Individual
JUSITH A AMPARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
707 S GREENVILLE WEST DR, GREENVILLE, MI 48838-2102
(616) 754-3001
Mailing address
100 MICHIGAN ST NE MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101011802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3443040-11
—
MI
Enumeration date
10/24/2006
Last updated
02/24/2021
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