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Individual

KELLY HEIKKINEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
26285 EXTENSION RD, CALUMET, MI 49913-1777
(906) 337-5468
Mailing address
5006 PARK AVE, CALUMET, MI 49913-1826

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16855184
CLIENT ID NUMBER
MI
Enumeration date
01/29/2015
Last updated
09/10/2015
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