Individual
KALLIE ANN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1471 GRACE STREET SE, GRAND RAPIDS, MI 49506
(616) 913-2007
Mailing address
6971 9 MILE RD NE, ROCKFORD, MI 49341-9633
(616) 690-0050
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302024237
MI
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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