Individual
CORY JON DRIESENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5225 EASTERN AVE SE, KENTWOOD, MI 49508-6009
(616) 261-3662
Mailing address
6681 E MILL RUN SE, CALEDONIA, MI 49316-9157
(616) 212-3975
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302415311
MI
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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