Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2601001411 | MI |
Y | 213ES0000X | Sports Medicine | 2601001411 | MI |
NPI | 1144737594 |
---|---|
Provider Name | Taylor Hoekwater |
First Address | Mount Pleasant, MI 48858-2632 |
Second Address | Mount Pleasant, MI 48859-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 08/01/2018 |