Individual
KELLY BACKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 W HURON ST, WATERFORD, MI 48328-3730
(248) 681-1880
Mailing address
1012 W HURON ST, WATERFORD, MI 48328-3730
(248) 681-1880
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007474
MI
Other
Enumeration date
09/08/2015
Last updated
03/31/2017
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