Individual
KAELY SHAYE CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-7200
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601008778
MI
Other
Enumeration date
09/04/2018
Last updated
02/17/2023
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