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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. KRYSTLE RUSSOW, RRT

Active Sole Proprietor

MRS. KRYSTLE RUSSOW, RRT is a 2279P3800X healthcare provider located in DETROIT, Michigan. NPI 1063076081 is currently active in the NPPES registry. Verify at CMS.

2279P3800X · DETROIT, MI

Registration Details

NPI Number
1063076081
Provider Type
Individual
Gender
Female
NPI Issued
Apr 25, 2019 (7.2809443170745 yrs)
Last Updated
Apr 25, 2019
License
4401006619 (MI)
Sole Proprietor
Yes

Practice Information

Address
4646 JOHN R ST
DETROIT, MI, 482011916
Browse MI providers · Browse ZIP 48201
Phone
3136719555
Primary Specialty
2279P3800X
2279P3800X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.