| Organization Name: | FOOT AND ANKLE SPECIALISTS OF WEST MICHIGAN PLLC |
| NPI Number: | 1417155508 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTI DYKSTRA (BILLING MANAGER) |
| Mailing Address: | 1195 Wilson Nw Grand Rapids |
| State: | MI US |
| Postal Code: | 495346404 |
| Phone Number: | 6164538277 |
| Fax Number: | 6164532002 |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | WD000997 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |