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1104276021
KATHERINE ELEANOR DERTZ
GRAND RAPIDS, MI
NPI
1104276021
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI 4301109765)
Enumeration Date
2016-06-22
Last Update Date
2016-10-25
Business Address
Dr. KATHERINE ELEANOR DERTZ M.D.
945 OTTAWA AVE NW
GRAND RAPIDS, MI 49503-1431
Phone number: 616-391-1929
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Mailing Address
Dr. KATHERINE ELEANOR DERTZ M.D.
945 OTTAWA AVE NW
GRAND RAPIDS, MI 49503-1431
Phone number: 616-391-1929
Copy
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