Keith Thomas Hustak
ActiveMichigan license 5601004306
License
- Licensed by
- Michigan Department of Licensing and Regulatory Affairs
- License number
- 5601004306
- Status
- Active
- First issued
- July 15, 2004
- Expires
- July 15, 2028
- License holder
- Keith Thomas Hustak
- Entity type
- Individual
Classifications
- Physicians Assistant Physicians & Surgeons
Contact
648 Monroe Ave NW
Suite 115
Grand Rapids, MI 49503
Suite 115
Grand Rapids, MI 49503
Kent County