Individual
JASON R KALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 722-4091
Mailing address
8989 N DIVISION AVE, SPARTA, MI 49345-8257
(616) 889-6173
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
07/12/2019
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