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Individual

KELLY SUE EDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1673 ALLENDALE DR, SAGINAW, MI 48638-4457
(989) 791-7054
Mailing address
1673 ALLENDALE DR, SAGINAW, MI 48638-4457
(989) 791-7054

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5202004388
MI

Other

Enumeration date
05/28/2012
Last updated
05/28/2012
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