KELLY A BANNASCH

DETROIT, MI
NPI1043330889
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: MI  5601002420)
Enumeration Date2007-03-29
Last Update Date2012-01-24
Business Address
-- KELLY A BANNASCH PA-C
6071 W OUTER DR
DETROIT, MI 48235-2624
Phone number: 313-966-8559
Mailing Address
-- KELLY A BANNASCH PA-C
6071 W OUTER DR
DETROIT, MI 48235-2624
Phone number: 313-966-8559
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