Individual
AMANDA THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W GREENLAWN AVE STE 230, LANSING, MI 48910-0812
(517) 485-8217
Mailing address
405 W GREENLAWN AVE STE 230, LANSING, MI 48910-0812
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4704297098
MI
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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