Individual
KELLI SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20291 HICKORY ST, DETROIT, MI 48205-1132
(313) 758-7020
Mailing address
20291 HICKORY ST, DETROIT, MI 48205-1132
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703127501
MI
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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