Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101021083 | MI |
NPI | 1033523535 |
---|---|
Provider Name | Dr. Christie Mckinney |
First Address | Grand Rapids, MI 49503-5229 |
Second Address | Trenton, MI 48183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2014 |
Last Update Date | 24/07/2018 |