Individual
MR. CRISTIAN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2155 BUCHANAN ST SW, GRAND RAPIDS, MI 49507
(616) 247-3638
Mailing address
2155 BUCHANAN ST SW, GRAND RAPIDS, MI 49507
(616) 247-3638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601006045
MI
363AM0700X
Medical Physician Assistant
Primary
5601006045
MI
Other
Enumeration date
08/03/2011
Last updated
12/09/2020
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