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Individual

PATON MCCOY RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
308 W CIRCLE DR, EAST LANSING, MI 48824-3700
(517) 420-8642
Mailing address
7204 E GRAND RIVER AVE LOT 53, PORTLAND, MI 48875-8763
(517) 420-8642

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/05/2024
Last updated
06/05/2024
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