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Individual

ANNE SLACHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
965 S BAILEY AVE, SUITE 2-1, SOUTH HAVEN, MI 49090-9701
(269) 639-2772
(269) 639-2770
Mailing address
649 MAPLE CREEK DR, HOLLAND, MI 49423-5448
(269) 397-3244

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003083
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5601003083
PHYS ASST. LICE NUMBER
Enumeration date
07/12/2006
Last updated
05/11/2021
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