Individual
MICHAEL PATRICK CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Mailing address
11890 IMLAY CITY RD, EMMETT, MI 48022-2508
(810) 523-2793
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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