Individual
KELLY MARIE KORNELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 EXPO DR, MANITOWOC, WI 54220-9341
(920) 684-4429
(920) 684-6892
Mailing address
PO BOX 1900, 4801 EXPO DR, MANITOWOC, WI 54221-1900
(920) 684-4429
(920) 684-6892
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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