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Individual

DR. GLENN A HOORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
854 S. WASHINGTON AVENUE, SUITE 430, HOLLAND, MI 49423-7141
(616) 392-6117
(616) 392-1920
Mailing address
854 S. WASHINGTON AVENUE, SUITE 430, HOLLAND, MI 49423-7141
(616) 392-6117
(616) 392-1920

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901000884
MI
213ES0131X
Foot Surgery Podiatrist
5901000884
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2115198
MI
01
480000546
ADMINISTAR
MI
01
4857005000
BLUECROSSBLUESHIELDMI
MI
01
485705000
BLUE CROSS BLUE SHEILD
MI
Enumeration date
12/11/2006
Last updated
02/25/2015
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