Individual
GRETCHEN KOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3403
Mailing address
22250 PROVIDENCE DRIVE, 6 PMB SUITE #601, SOUTHFIELD, MI 48075-4818
(248) 569-7745
(248) 569-4539
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
5151016812
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/09/2023
Last updated
05/23/2024
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