Individual
LISA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
949 WOODSIDE RD APT 20, MUSKEGON, MI 49441-4161
(616) 223-8338
Mailing address
949 WOODSIDE RD APT 20, MUSKEGON, MI 49441-4161
(616) 223-8338
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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