Individual
KELLY S TEFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 MICHIGAN ST NE, SUITE 8861, GRAND RAPIDS, MI 49503-2560
(616) 391-0800
(616) 391-0801
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004983
MI
Other
Enumeration date
06/14/2007
Last updated
03/03/2021
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