Individual
MR. DAVID MELVIN RUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2514 PETIT ST, PORT HURON, MI 48060-7447
(810) 434-9501
Mailing address
2514 PETIT ST, PORT HURON, MI 48060-7447
(810) 434-9501
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/30/2017
Last updated
12/30/2017
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