Individual
KELLY EATON-KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1137 MORELAND ST, GRAND HAVEN, MI 49417-2821
(616) 607-8030
Mailing address
1137 MORELAND ST, GRAND HAVEN, MI 49417-2821
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
474235719
MI
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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