Provider Demographics
NPI:1952712192
Name:KORYTKOWSKI, KARI ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANNE
Last Name:KORYTKOWSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7809 ROBERTSON RUN NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8757
Mailing Address - Country:US
Mailing Address - Phone:616-863-9293
Mailing Address - Fax:
Practice Address - Street 1:2799 10 MILE RD NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9100
Practice Address - Country:US
Practice Address - Phone:616-863-3433
Practice Address - Fax:616-863-3465
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020307511835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy