Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1285265868 |
---|---|
Provider Name | Anna Ockaskis |
First Address | Grand Rapids, MI 49505-6005 |
Second Address | Allendale, MI 49401-8844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2020 |
Last Update Date | 31/01/2020 |