Individual
KELSEY ELYSE PENEBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2992 BIRCH HOLLOW DR APT 1B, ANN ARBOR, MI 48108-2336
(414) 975-4436
Mailing address
2992 BIRCH HOLLOW DR APT 1B, ANN ARBOR, MI 48108-2336
(414) 975-4436
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001295
MI
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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