Individual
KELLE PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44706 BAYVIEW AVE APT # 19212, CLINTON TOWNSHIP, MI 48038
(313) 674-0044
Mailing address
44706 BAYVIEW APT # 19212, CLINTON TOWNSHIP, MI 48038
(313) 674-0044
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703087310
MI
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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