Individual
JENNA MARIE RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
27450 SCHOENHERR RD STE 400, WARREN, MI 48088-6684
(586) 582-7550
(586) 582-7515
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101021472
MI
207Q00000X
Family Medicine Physician
Primary
68353-21
WI
Other
Enumeration date
09/25/2014
Last updated
12/28/2017
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