Individual
CHRISTINE A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSRD
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
800538
MI
Other
Enumeration date
05/28/2013
Last updated
01/23/2020
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