Individual
JOHANNA KEGERREIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2995 WOLF LAKE RD, GRASS LAKE, MI 49240-9825
(517) 416-2807
Mailing address
2995 WOLF LAKE RD, GRASS LAKE, MI 49240-9825
(517) 416-2807
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/21/2024
Last updated
11/21/2024
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