Individual
KELLY EHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2974 28TH ST SE, STE A, KENTWOOD, MI 49512-1664
(616) 949-2120
(616) 949-9015
Mailing address
7302 SILVER RIDGE DR NE, ROCKFORD, MI 49341-7668
(616) 874-3318
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004378
MI
Other
Enumeration date
12/04/2006
Last updated
03/08/2010
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