Individual
MRS. KAYLENE RENEE MATHIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
104 DALMAR DR, KINGSFORD, MI 49802-6620
(906) 779-5010
(906) 563-8942
Mailing address
104 DALMAR DR, KINGSFORD, MI 49802-6620
(906) 779-5010
(906) 563-8942
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2303
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
670B210470
BCBS
MI
Enumeration date
05/12/2006
Last updated
10/11/2007
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