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Individual

DR. BRIAN MATTHEW KREISMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2907 BRETON RD SE, GRAND RAPIDS, MI 49512-1745
(616) 914-2020
Mailing address
2848 BELLEGLADE CT SE, GRAND RAPIDS, MI 49546-8011
(616) 914-2020

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000622
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1601000622
STATE OF MICHIGAN AUDIOLOGY LICENSE
MI
Enumeration date
05/12/2022
Last updated
07/30/2023
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