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Organization

PATRICK J KIELLA OD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICK J KIELLA OD (OPTOMETRIST)
(231) 947-9500
Entity
Organization

Contact information

Practice address
522 S GARFIELD AVE, TRAVERSE CITY, MI 49686-3452
(231) 947-9500
Mailing address
PO BOX 687, TRAVERSE CITY, MI 49685-0687
(231) 947-9500

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002752
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
900B86507
BLUE CROSS OF MI
MI
Enumeration date
02/26/2008
Last updated
04/20/2008
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