Individual
ORIN A KELLY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4856 N 40TH ST, MILWAUKEE, WI 53209-5204
(414) 759-2276
Mailing address
4856 N 40TH ST, MILWAUKEE, WI 53209-5204
(414) 759-2276
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
K4006417318200
WI
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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