Individual
ROBERT CLARK KRICHBAUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP
Contact information
Practice address
2561 ELIZABETH LAKE RD, WATERFORD, MI 48328-3313
(248) 682-3300
Mailing address
1021 MONTERO RD NE, CARROLLTON, OH 44615-9165
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704388574
MI
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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