Individual
MRS. KELLY JEAN BULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 N MAPLE, GRANT, MI 49327
(231) 834-0444
(231) 834-0200
Mailing address
11 N MAPLE ST, PO BOX 7, GRANT, MI 49327-7900
(231) 834-0444
(231) 834-0200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004124
MI
Other
Enumeration date
07/12/2006
Last updated
10/14/2021
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