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General NPI Number Information
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NPI Number | 1669721031
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Entity Type | Individual
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Provider Name | JAMES MICHAEL VUGTEVEEN MS,OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 10263 CHICAGO DR
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City | ZEELAND
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State | MI
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Zip | 49464-1416
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Country | US
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Telephone | 616-822-1117
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 RIVERBEND DR SW
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-6611
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Country | US
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Telephone | 616-822-1117
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5201005965
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License Number State | MI
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