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1053353946
KENNETH D ROOT
GRAND RAPIDS, MI
NPI
1053353946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601003447)
Enumeration Date
2006-06-12
Last Update Date
2017-08-15
Business Address
KENNETH D ROOT PA-C
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546-8292
Phone number: 616-391-3759
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Mailing Address
KENNETH D ROOT PA-C
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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