Individual
KELLY KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
Mailing address
355 OAK PARK ST, SUMMERVILLE, SC 29486-2088
(843) 270-9456
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
000150
DE
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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