Individual
MRS. KELLI LYNN FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
15750 NORTHLINE RD, SOUTHGATE, MI 48195-2378
(734) 283-7511
(734) 283-6880
Mailing address
15750 NORTHLINE RD, SOUTHGATE, MI 48195-2378
(734) 283-7511
(734) 283-6880
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005677
MI
Other
Enumeration date
10/13/2009
Last updated
10/13/2009
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