Individual
DANIELLE DIEKEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MICHIGAN ST NE # MC019, GRAND RAPIDS, MI 49503-2560
(616) 391-1969
(616) 391-6248
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MI
Other
Enumeration date
11/18/2014
Last updated
03/02/2021
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