Individual
IAN CHRISTOPHER KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13329 PORTAGE RD, VICKSBURG, MI 49097-9496
(269) 649-2400
(269) 649-0548
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501302420
MI
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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