Individual
SALLY VELLENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8450 N 32ND ST, RICHLAND, MI 49083-9418
(269) 226-2500
Mailing address
5943 STADIUM DR, SUITE 3, KALAMAZOO, MI 49009-3016
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704118351
MI
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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