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1356199467
KETURA DICKINSON-HENDERSHOT
GRAND RAPIDS, MI
NPI
1356199467
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601012398)
Enumeration Date
2024-05-13
Last Update Date
2024-09-26
Business Address
KETURA DICKINSON-HENDERSHOT PA-C
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-1730
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Mailing Address
KETURA DICKINSON-HENDERSHOT PA-C
4100 EMBASSY DR SE
GRAND RAPIDS, MI 49546-2416
Phone number: 616-988-8220
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