Provider Demographics
NPI:1942894886
Name:BELCHER, CANDICE (CRANIAL PROSTHESIS)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:BELCHER
Suffix:
Gender:F
Credentials:CRANIAL PROSTHESIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1782 52ND ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4987
Mailing Address - Country:US
Mailing Address - Phone:616-329-0908
Mailing Address - Fax:
Practice Address - Street 1:1782 52ND ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4987
Practice Address - Country:US
Practice Address - Phone:616-329-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment