Individual
MISS DANIELLE MARIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
558 ASHMUN ST, SAULT SAINTE MARIE, MI 49783-4001
(906) 635-9090
(906) 635-9091
Mailing address
550 OSBORN BLVD, SAULT SAINTE MARIE, MI 49783-1899
(906) 635-4460
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006193
MI
Other
Enumeration date
10/14/2011
Last updated
04/06/2018
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