Most Relevant Information
Provider Data
| NPI Number: | 1003540105 |
| Provider Name: | GRACIANA MARIE RIETEMA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/13/2022 |
| Last Updated: | 10/07/2024 |
Provider Practice Location
11652 W GRAND RIVER AVE
LOWELL
MI
493318465
Practice Location Phone/Fax
| Phone: | 6163020169 |
| Fax: |
Provider Mailing Location
11652 W GRAND RIVER AVE
LOWELL
MI
493318465
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |