Individual
CARSON ROBERT NOORDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1939 S DIVISION AVE., GRAND RAPIDS, MI 49507
(616) 247-3815
(616) 245-0450
Mailing address
1939 S DIVISION AVE., GRAND RAPIDS, MI 49507
(616) 247-3815
(616) 245-0450
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0312887
ASR
MI
Enumeration date
11/26/2018
Last updated
10/31/2019
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