Individual
JASON A. SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1900 WEALTHY ST SE STE 300, GRAND RAPIDS, MI 49506-2969
(616) 267-7293
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
247792
NY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
5101015566
MI
Other
Enumeration date
08/20/2007
Last updated
05/23/2023
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