Individual
TIMOTHY JAMES KELLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
905 N MACOMB ST STE 3, MONROE, MI 48162-3076
(734) 241-0560
(734) 241-3230
Mailing address
905 N MACOMB ST STE 3, MONROE, MI 48162-3076
(734) 241-0560
(734) 241-3230
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704285899
MI
163WM1400X
Nurse Massage Therapist (NMT)
7501000754
MI
225700000X
Massage Therapist
7501000754
MI
363L00000X
Nurse Practitioner
Primary
4704285899
MI
Other
Enumeration date
01/24/2017
Last updated
12/07/2023
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