Individual
KATHY MELVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 S GRINNELL ST, JACKSON, MI 49203-1683
(517) 990-4690
Mailing address
507 S GRINNELL ST, JACKSON, MI 49203-1683
(517) 990-4690
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704179692
MI
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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