Individual
RYAN RENFRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-3994
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
89984
SC
390200000X
Student in an Organized Health Care Education/Training Program
4351045174
MI
Other
Enumeration date
07/01/2019
Last updated
07/21/2023
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