Individual
KELLY RAYE SALIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3097 PRAIRIE ST SW, GRANDVILLE, MI 49418-2000
(616) 531-9973
(616) 531-5577
Mailing address
8165 DIETZ RD, BELDING, MI 48809-9408
(616) 894-4568
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704206999
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704206999
—
MI
Enumeration date
02/07/2020
Last updated
02/07/2020
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