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MR. MICHAEL HENRY DYKSTRA R.T. (R)

Technologists, Technicians & Other Technical Service Providers Radiologic Technologist Radiography

Provider NPI: 1124424908

Provider Information:
MR. MICHAEL HENRY DYKSTRA R.T. (R)
Gender: M
Sole Proprietor

Practice Location:
5314 BANNON CROSSINGS DR  BUECHEL, KY 40218-4023 US
Tel: 502-320-7456  Fax: --

Business Mailing Address:
5314 BANNON CROSSINGS DR  BUECHEL, KY 40218-4023 US
Tel: 502-320-7456  Fax: --

NPI Information:
NPI: 1124424908
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2471C3402XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
Radiography
KY10-056-10860
Y2471C3402XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MN473124

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 2471C3402X

Type:

Classification:



Definition:



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