Healthcare Provider Details

I. General information

NPI: 1033231923
Provider Name (Legal Business Name): KREMER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 FRONT AVE NW SUITE 311
GRAND RAPIDS MI
49504-4400
US

IV. Provider business mailing address

750 FRONT AVE NW SUITE 311
GRAND RAPIDS MI
49504-4400
US

V. Phone/Fax

Practice location:
  • Phone: 616-459-8971
  • Fax: 616-459-2361
Mailing address:
  • Phone: 616-459-8971
  • Fax: 616-459-2361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801070616
License Number StateMI

VIII. Authorized Official

Name: SARA KREMER-START
Title or Position: OFFICE MANAGER
Credential:
Phone: 616-459-8971