Individual
MR. KIPP EDWARD RUSTENHOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3413 WOODS EDGE, OKEMOS, MI 48864-5901
(517) 349-3303
Mailing address
1147 TEAKWOOD CIR, HASLETT, MI 48840-9734
(517) 339-0188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MI
Other
Enumeration date
05/07/2008
Last updated
11/15/2024
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