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1669162616
DEREK S VERSALLE
KALAMAZOO, MI
NPI
1669162616
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI 5151016178)
Enumeration Date
2023-05-12
Last Update Date
2023-05-23
Business Address
DEREK S VERSALLE DO
1000 OAKLAND DR
KALAMAZOO, MI 49008-1284
Phone number: 269-337-6600
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Mailing Address
DEREK S VERSALLE DO
1000 OAKLAND DR
KALAMAZOO, MI 49008-1284
Phone number: 269-337-6600
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