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Individual

ALEXANDER TIMOTHY DICKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
500 LAFAYETTE AVE, BAY CITY, MI 48708-7854
(989) 893-5200
Mailing address
500 LAFAYETTE AVE, BAY CITY, MI 48708-7854
(989) 893-5200

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
P041184
183700000X
Pharmacy Technician
Primary
5303039917
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1516581120
MI
Enumeration date
01/07/2022
Last updated
01/07/2022
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