Individual
MADDISON DINNEWETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
301 N MAIN ST, LAKE CITY, MI 49651-5102
(231) 295-1196
Mailing address
310 N FRONT, LAKE CITY, MI 49651-9307
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
85004
MI
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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