Individual
KRISTEN DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2036 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-4743
(616) 453-2473
Mailing address
2036 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-4743
(616) 453-2473
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302031012
MI
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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