Individual
JOEL FREDRIC KORTGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10785 S SAGINAW ST, STE. A., BLDG. E, GRAND BLANC, MI 48439-7003
(810) 695-0055
(810) 695-6813
Mailing address
5086 OLD COVE RD, CLARKSTON, MI 48346-3817
(248) 623-4834
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301009397
MI
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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