Individual
KENT FRANCES DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2036 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-4743
(616) 453-8750
(616) 453-0107
Mailing address
2036 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-4743
(616) 453-8750
(616) 453-0107
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302031457
MI
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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