Individual
BRIAN KENT LLEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
122 S RAWLES STREET, SUITE 112, ROMEO, MI 48065-5177
(586) 752-6111
Mailing address
122 S RAWLES STREET, SUITE 112, ROMEO, MI 48065-5177
(586) 752-6111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006643
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950E05220
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/26/2008
Last updated
03/26/2008
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