Individual
DR. KEVIN DIECKMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
655 W SANILAC RD, SANDUSKY, MI 48471-9667
(810) 648-4247
Mailing address
655 W SANILAC RD, SANDUSKY, MI 48471-9667
(810) 648-4247
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028828
MI
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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