Organization
GREAT LAKES SPINE AND MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A KELLY DC (OWNER)
(989) 792-6702
Entity
Organization
Contact information
Practice address
4573 WILLOUGHBY RD STE B, HOLT, MI 48842-2188
(517) 699-2646
(517) 699-5434
Mailing address
4573 WILLOUGHBY RD STE B, HOLT, MI 48842-2188
(517) 699-2646
(517) 699-5434
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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