Individual
KELLY LYNN SPROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
72088
OH
Other
Enumeration date
01/13/2007
Last updated
12/05/2019
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