Individual
MRS. KRISTY KAY DEITERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
576 ROMENCE RD, STE. 121, PORTAGE, MI 49024-3472
(269) 324-0555
(269) 324-2482
Mailing address
576 ROMENCE RD, STE. 121, PORTAGE, MI 49024-3472
(269) 324-0555
(269) 324-2482
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000590
MI
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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