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General NPI Number Information
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NPI Number | 1174780969
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Entity Type | Individual
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Provider Name | GRETCHEN WINTERS RPH
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Gender | Female
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1838 BRETON RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4869
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Country | US
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Telephone | 616-949-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 2598 87TH ST SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-9236
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Country | US
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Telephone | 616-450-9385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302035747
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License Number State | MI
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