Individual
KELLY HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 SAND CREEK HWY, ADRIAN, MI 49221-9129
(734) 793-6140
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
4401001347
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4401001347
RT LIC
MI
Enumeration date
03/29/2016
Last updated
03/29/2016
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