Individual
KRISTA MARIE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22101 MOROSS RD, UNIT 7-NORTH, ORTHOPEDIC SURGERY, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601007828
MI
363AS0400X
Surgical Physician Assistant
Primary
5601007828
MI
Other
Enumeration date
07/02/2016
Last updated
09/14/2022
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