Individual
MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
1217 E IRELAND RD, SOUTH BEND, IN 46614-3448
(574) 291-0740
Mailing address
9246 RED ARROW HWY, BRIDGMAN, MI 49106-9591
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302045631
MI
Other
Enumeration date
12/12/2017
Last updated
06/30/2026
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