Individual
MELANE KERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2601 ELECTRIC AVE, PORT HURON, MI 48060-6587
(810) 216-1800
Mailing address
3870 BABCOCK RD, LEXINGTON, MI 48450-9525
(810) 841-5570
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009068
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306227764
—
MI
Enumeration date
06/13/2018
Last updated
06/13/2018
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