Individual
DR. KELLI ANNE WILCOX-DEGRAAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
5900 ALPINE AVE NW, COMSTOCK PARK, MI 49321-9717
(616) 784-5433
(616) 784-3577
Mailing address
5900 ALPINE AVE NW, COMSTOCK PARK, MI 49321-9717
(616) 784-5433
(616) 784-3577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009030
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D11549
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
08/27/2006
Last updated
08/15/2011
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