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Individual

MRS. KRYSTLE RUSSOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RRT

Contact information

Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 671-9555
Mailing address
7413 RED BIRD DR, YPSILANTI, MI 48197-9454
(313) 671-9555

Taxonomy

Speciality
Code
Description
License number
State
2279P3800X
Palliative/Hospice Registered Respiratory Therapist
Primary
4401006619
MI

Other

Enumeration date
04/25/2019
Last updated
04/25/2019
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