Organization
KEVIN KELLOGG MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA LISZEWSKI (OFFICE MANAGER)
(231) 563-6580
Entity
Organization
Contact information
Practice address
512 S BEAR LAKE RD, NORTH MUSKEGON, MI 49445-2372
(231) 563-6580
Mailing address
512 S BEAR LAKE RD, NORTH MUSKEGON, MI 49445-2372
(231) 563-6580
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KK073336
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3510652
—
MI
Enumeration date
10/11/2006
Last updated
05/03/2021
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