Individual
JEANNE KOISTINEN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3346 LENNON ROAD, FLINT, MI 48507-1015
(810) 732-1919
(810) 732-1945
Mailing address
3346 LENNON ROAD, SUITE 2, FLINT, MI 48507-1015
(810) 732-1919
(810) 732-3740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301048681
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301048681
MI
Other
Enumeration date
07/24/2006
Last updated
08/23/2011
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