Individual
KEZIA AURALYA TJAHJANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 3RD ST, MUSKEGON, MI 49441-2170
(231) 722-9622
Mailing address
1115 3RD ST, MUSKEGON, MI 49441-2170
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/14/2021
Last updated
08/29/2023
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