Individual
ASHLEY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20140 FORT ST, RIVERVIEW, MI 48193-8773
(313) 829-3848
Mailing address
20140 FORT ST, RIVERVIEW, MI 48193-8773
(313) 829-3848
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116304
MI
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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