Individual
BENJAMIN JOHN HAVENAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
610 BALDWIN ST, JENISON, MI 49428
(616) 608-8930
Mailing address
PO BOX 30516, DEPT 5300, LANSING, MI 48909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-32680
AZ
Other
Enumeration date
11/15/2022
Last updated
02/26/2024
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