Provider Demographics
NPI:1205801487
Name:HUYSER, KENT (ATC, PTA)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:HUYSER
Suffix:
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 PARIS PARK DR SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-9690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1535 44TH ST SW
Practice Address - Street 2:SUITE 300
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-4481
Practice Address - Country:US
Practice Address - Phone:616-530-1977
Practice Address - Fax:616-530-2140
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer