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Individual

MR. KENNETH PAUL HAAGSMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OCCUPATIONAL THERAPI

Contact information

Practice address
4072 LILA AVE SW, GRANDVILLE, MI 49418
(616) 644-1050
Mailing address
4072 LILA AVE SW, GRANDVILLE, MI 49418
(616) 644-1050

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000994
MI

Other

Enumeration date
08/29/2007
Last updated
08/29/2007
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