KENNETH D ROOT

GRAND RAPIDS, MI
NPI1053353946
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601003447)
Enumeration Date2006-06-12
Last Update Date2017-08-15
Business Address
-- KENNETH D ROOT PA-C
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546-8292
Phone number: 616-391-3759
Mailing Address
-- KENNETH D ROOT PA-C
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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