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General NPI Number Information
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NPI Number | 1417934050
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Entity Type | Organization
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Legal Business Name | HOLLAND FOOT AND ANKLE CENTER PC
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Dates
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Enumeration Date | 12/24/2005
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 904 S WASHINGTON AVE
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City | HOLLAND
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State | MI
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Zip | 49423-7724
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Country | US
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Telephone | 616-392-7472
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Fax | 616-392-3327
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Provider Business Mailing Address
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Address Line | 904 WASHINGTON AVE
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City | HOLLAND
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State | MI
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Zip | 49423-7724
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Country | US
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Telephone | 616-392-7472
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Fax | 616-392-3327
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATT J LAPPENGA
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Credential | DPM
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Telephone | 616-392-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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