Individual
COURTNEY T VANDERBROEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
601 JOHN ST STE M-124, KALAMAZOO, MI 49007-5377
(269) 341-7500
Mailing address
3902 MAYFIELD AVE NE APT 2B, GRAND RAPIDS, MI 49525-6601
(810) 626-8829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009609
MI
Other
Enumeration date
10/16/2019
Last updated
12/17/2020
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