Individual
KENNETH VANSUMEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
301 W WACKERLY ST, MIDLAND, MI 48640-2761
(989) 832-0900
(989) 633-0349
Mailing address
301 W WACKERLY ST, MIDLAND, MI 48640-2761
(989) 832-0900
(989) 633-0349
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003931
MI
Other
Enumeration date
08/03/2006
Last updated
09/19/2012
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