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1003217860
KELLY MALIA PETERSON
MUSKEGON, MI
NPI
1003217860
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601007197)
Enumeration Date
2014-09-11
Last Update Date
2019-08-05
Business Address
KELLY MALIA PETERSON PA-C
1301 MERCY DRIVE
MUSKEGON, MI 49444
Phone number: 231-739-9492
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Mailing Address
KELLY MALIA PETERSON PA-C
3621 S STATE ST
ANN ARBOR, MI 48108-1633
Phone number: 734-647-5299
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