Individual
JENNIFER MARIE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
418 W KALAMAZOO AVE, KALAMAZOO, MI 49007-3334
(269) 373-6000
Mailing address
2305 OAKLAND DR, KALAMAZOO, MI 49008-2249
(269) 599-1625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006439
MI
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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