Individual
JUSTIN RYAN-STUART SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5000
Mailing address
8888 M 115, CADILLAC, MI 49601-9787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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