Individual
MRS. MARIANNE DOLORES MCKISSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3350 GRATIOT BLVD, MARYSVILLE, MI 48040-2121
(810) 364-4000
(810) 364-5995
Mailing address
3350 GRATIOT BLVD, MARYSVILLE, MI 48040-2121
(810) 364-4000
(810) 364-5995
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003532
MI
Other
Enumeration date
05/12/2008
Last updated
10/08/2013
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