Individual
KRISTINA KATHERINE SUSALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 E MEDICAL CENTER DR, B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY, ANN ARBOR, MI 48109-5301
(734) 936-6666
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007812
MI
Other
Enumeration date
06/06/2016
Last updated
01/11/2019
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