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General NPI Number Information
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NPI Number | 1164818332
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Entity Type | Individual
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Provider Name | PATRICK HOEKSTRA
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Gender | Male
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 221 TROWBRIDGE ST
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City | ALLEGAN
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State | MI
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Zip | 49010-1340
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Country | US
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Telephone | 616-648-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 MAYBERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-1525
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Country | US
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Telephone | 931-338-2238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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