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Contact Information

LAKE FOCO, DPT
17272 ROBBINS RD STE 102
GRAND HAVEN, MI49417-2677
 Phone: 616-256-8670
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LAKE FOCO · (Male)

NPI # 1407630643
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 08/21/2023
Last updated 04/22/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MI Other 5501302860 STATE LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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