Individual
ZACHARY KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25602 W 12 MILE RD, SOUTHFIELD, MI 48034-8039
(313) 221-0260
Mailing address
25602 W 12 MILE RD, SOUTHFIELD, MI 48034-8039
(313) 221-0260
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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