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Individual

JAMES D BIEDERBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
8354 100TH AVE, SUITE 2, CANADIAN LAKES, MI 49346-8333
(231) 972-1040
(231) 972-1041
Mailing address
607 DEWEY AVE NW, STE 300, GRAND RAPIDS, MI 49504-5283
(616) 241-1809

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010397
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619912714
NPI
MI
01
1649216144
GROUP NPI
MI
01
5501010397
STATE OF MICHIGAN
MI
01
650G012500
BCBS
MI
Enumeration date
06/20/2006
Last updated
05/27/2021
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