Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 5501002672 | MI |
N | 225XE1200X | Ergonomics | 5501002672 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | 5501002672 | MI |
NPI | 1225044183 |
---|---|
Provider Name | Mr. Scott David Macdonald |
First Address | West Olive, MI 49460-9634 |
Second Address | Allendale, MI 49401-8200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |