Most Relevant Information
Provider Data
| NPI Number: | 1003257205 |
| Provider Name: | JON JOSEPH FAKLER RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 4704139382 |
Most Important Dates
| Enumeration Date: | 07/16/2013 |
| Last Updated: | 07/16/2013 |
Provider Practice Location
955 W BROADWAY AVE
MUSKEGON
MI
494413521
Practice Location Phone/Fax
| Phone: | 2317550637 |
| Fax: | 2317556208 |
Provider Mailing Location
706 MYRTLE AVE
HOLLAND
MI
494236830
Provider Mailing Phone/Fax
| Phone: | 2317550637 |
| Fax: | 2317556208 |