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1780430702
KELLY ANN RUSSELL
DETROIT, MI
NPI
1780430702
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI 4351053278)
Enumeration Date
2024-04-29
Last Update Date
2024-05-17
Business Address
KELLY ANN RUSSELL MD
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number: 313-916-2600
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Mailing Address
KELLY ANN RUSSELL MD
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number: 313-916-2600
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