NPI 1710902945

Joan M Griner Licht, MD

Practitioner Procedural Dermatology Physician Traverse City, MI

Practice location

Address: 3643 W Front St STE a, Traverse City, MI 49684-7760
Phone: (231) 935-0620
Fax: (231) 935-0626
Mailing address: 3643 W Front St Suite a, Traverse City, MI 49684-7759

Registered specialties

Procedural Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X Licence JG058054 (MI)

Other Dermatology providers in Michigan →

Registry record

NPI: 1710902945
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Jul 2006
Record last updated: 21 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.