KENNETH ROOT, PA-C

Physician Assistant

Active Individual
NPI: 1053353946

Practice Address

4100 LAKE DR SE STE 200
Grand Rapids, MI 49546

Phone: (616) 391-3759

Specialties

Specialty Code Primary License
Physician Assistant 363A00000X Yes 5601003447 (MI)

Frequently Asked Questions

NPI 1053353946 is the National Provider Identifier for KENNETH ROOT, PA-C, a Physician Assistant provider located in Grand Rapids, MI. This NPI was enumerated on June 12, 2006.
KENNETH ROOT, PA-C practices at 4100 LAKE DR SE STE 200, Grand Rapids, MI 49546.

Quick Facts

NPI
1053353946
Type
Individual
Enumerated
Jun 12, 2006
Last Updated
Aug 15, 2017

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