MEDICARE: RECOVER HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	171400000X	Health & Wellness Coach
3	174200000X	Meals Provider
4	202D00000X	Integrative Medicine Physician
5	2083B0002X	Obesity Medicine (Preventive Medicine) Physician
6	363A00000X	Physician Assistant
7	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1376276345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVER HEALTH, PLLC

Provider Business Mailing Address
First Line	:	1345 MONROE AVE NW STE 121
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-4671
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1345 MONROE AVE NW STE 121
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-4671
Country	:	US
Telephone Number	:	616-256-8600
Fax Number	:	877-409-3462

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT RUSSO
Credential	:	MD
Telephone Number	:	616-256-8600

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	02/28/2023

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Directions to “RECOVER HEALTH, PLLC ” Practice Location

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