Individual
DR. ANTONIA JOCELYN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2093 HEALTH DR SW STE 302, WYOMING, MI 49519-9691
(616) 252-5775
(616) 252-5269
Mailing address
2093 HEALTH DR SW STE 302, WYOMING, MI 49519-9691
(616) 252-5775
(616) 252-5269
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
229207
MA
208600000X
Surgery Physician
Primary
4301501661
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301501661
MEDICAL LICENSE
MI
Enumeration date
12/14/2006
Last updated
02/26/2024
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