Kooistra, Charles Scott

Kooistra, Charles Scott is an sole proprietor health care provider with primary practice located at 2855 Byron Center Ave Sw , Wyoming MI 49519-2415. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Kooistra, Charles Scott can be contacted via phone (616) 532-2518.

Contact Information

Primary practice address
2855 Byron Center Ave Sw Wyoming MI 49519-2415
Fax: (616) 532-2696
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CK002664 Michigan

Profile Details

NPI number 1417943036
LBN Legal business name Kooistra, Charles Scott
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Feb 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417943036 NPPES
Other 950D150810 BCBS

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