Dr. Russell Frederick Labeau Jr.
General Practice in Petoskey, MI. Individual provider (NPI-1).
NPI number1881908671
StatusActive
Last updated in NPPESAug 4, 2010
Details
- NPI
- 1881908671
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell Frederick Labeau Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 4, 2010
- Last updated
- Aug 4, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 4301026523 | MI | Yes |
Practice location
402 Rolling Hills LnPetoskey, MI 49770-9602
Phone 231-347-5682 · Fax 231-347-5682
Mailing address
402 Rolling Hills LnPetoskey, MI 49770-9602
Phone 231-347-5682 · Fax 231-347-5682
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