Individual
KIRSTEN M JOHANTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7895 CURRIER DR, PORTAGE, MI 49002-4314
(269) 321-7080
Mailing address
5943 STADIUM DR, SUITE 3, KALAMAZOO, MI 49009-3016
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301054491
MI
Other
Enumeration date
09/01/2006
Last updated
12/08/2015
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