Individual
DIANE DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7369 OLD LANTERN DR SE, CALEDONIA, MI 49316-9004
(616) 890-7177
Mailing address
7369 OLD LANTERN DR SE, CALEDONIA, MI 49316-9004
(616) 890-7177
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/19/2016
Last updated
06/19/2016
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