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Individual

KELLYANN VANDENDOOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7 ATKINSON DR STE 200, LUDINGTON, MI 49431-1917
(231) 843-3717
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301111681
MI

Other

Enumeration date
07/23/2012
Last updated
02/16/2021
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