Individual
DAKOTA K DEGROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3850 GLENKERRY CT, PORTAGE, MI 49024-0700
(269) 327-7200
(269) 327-9272
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011875
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790561546
—
MI
Enumeration date
09/07/2023
Last updated
02/14/2024
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