JONATHAN MICHAEL RUSSELL

BIG RAPIDS, MI
NPI1174922447
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601007115)
Enumeration Date2014-08-22
Last Update Date2021-02-23
Business Address
JONATHAN MICHAEL RUSSELL PA-C
705 OAK ST UNIT 11
BIG RAPIDS, MI 49307-3108
Phone number: 231-592-1002
Mailing Address
JONATHAN MICHAEL RUSSELL PA-C
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-6790
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