Individual
JUSTIN R STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1700 CLINTON ST, MUSKEGON, MI 49442-5502
(231) 726-3511
Mailing address
1675 LEAHY ST STE 315A, MUSKEGON, MI 49442-5543
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101026712
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2020
Last updated
01/24/2024
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