Individual
KELLY POWELL OLIVERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19100 W 7 MILE RD, DETROIT, MI 48219-2758
(248) 660-1220
Mailing address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009515
MI
Other
Enumeration date
04/22/2019
Last updated
12/07/2022
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