Individual
KELLY HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
449 BAYBERRY POINTE DR NW, APT L, GRAND RAPIDS, MI 49534-4678
(616) 304-6996
Mailing address
449 BAYBERRY POINTE DR NW, APT L, GRAND RAPIDS, MI 49534-4678
(616) 304-6996
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001053
MI
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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