Healthcare Provider Details

I. General information

NPI: 1316282429
Provider Name (Legal Business Name): HOLLAND AUDIOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 E 32ND ST SUITE 70
HOLLAND MI
49423-5518
US

IV. Provider business mailing address

399 E 32ND ST SUITE 70
HOLLAND MI
49423-5518
US

V. Phone/Fax

Practice location:
  • Phone: 616-392-2222
  • Fax:
Mailing address:
  • Phone: 616-392-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000550
License Number StateMI

VIII. Authorized Official

Name: DR. STYLIANOS G DOKIANAKIS
Title or Position: OWNER
Credential: AU.D.
Phone: 616-392-2222