Individual
KELLY DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(586) 219-9498
Mailing address
8721 E PARK RIDGE CIR, NEWPORT, MI 48166-9290
(734) 777-6020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704298875
MI
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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