Individual
KELLI FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29616 JULIUS BLVD, WESTLAND, MI 48186-5129
(313) 818-8633
Mailing address
29616 JULIUS BLVD, WESTLAND, MI 48186-5129
(313) 818-8633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118036
MI
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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