Individual
MRS. ROBIN MAE DERTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4868 LAKE MICHIGAN DR, ALLENDALE, MI 49401-8434
(616) 391-7849
(616) 391-7896
Mailing address
3376 IVANREST AVE SW, GRANDVILLE, MI 49418-2020
(616) 893-1563
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501010918
MI
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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