Organization
KETAMINE INSTITUTE OF MICHIGAN
Active
Other names
Ketamine Institute of Michigan South
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTA IRENE KLYDER CRNA (CHIEF CRNA)
(734) 731-9500
Entity
Organization
Contact information
Practice address
98 WINCHESTER ST STE 100, MONROE, MI 48161-1957
(734) 605-8500
Mailing address
98 WINCHESTER ST STE 100, MONROE, MI 48161-1957
(734) 605-8500
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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