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Individual

DR. KELLY MARIE PROCAILO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
29965 MCINTYRE ST, LIVONIA, MI 48150-3026
(734) 612-7752
Mailing address
57679 CIDER MILL DR, NEW HUDSON, MI 48165-9480
(734) 612-7752

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302035561
MI

Other

Enumeration date
11/23/2010
Last updated
04/02/2012
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