Individual
KRISTA NICOLE TACKEBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7110 MICHIGAN RD, BAY CITY, MI 48706-9310
(989) 714-3400
Mailing address
7110 MICHIGAN RD, BAY CITY, MI 48706-9310
(989) 714-3400
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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