Individual
DR. KELLIE A PUROLL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
529 S WISCONSIN AVE, GAYLORD, MI 49735-1741
(989) 732-3035
(989) 732-7925
Mailing address
227 ALDOROVA DR, GAYLORD, MI 49735-9305
(989) 732-2939
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F95026
BLUE CROSS
MI
Enumeration date
06/16/2006
Last updated
07/08/2007
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