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Individual

ANGELA K KIEKOVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
601 MICHIGAN AVE, SUITE 220, HOLLAND, MI 49423-4951
(616) 355-4284
(616) 355-4285
Mailing address
601 MICHIGAN AVE, SUITE 220, HOLLAND, MI 49423-4951
(616) 355-4284
(616) 355-4285

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012402
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5501012402
MI STATE LICENSE
MI
01
65-0-G0-1466-0
BCBSM
MI
Enumeration date
02/14/2007
Last updated
10/24/2011
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