MICK KELLY

PEWAUKEE, WI
NPI1053793208
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207X00000X Orthopaedic Surgery
(Licence: WI  75716)
Additional Taxonomies207X00000X Orthopaedic Surgery
(Licence: IL  125066593)
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery
(Licence: UT  11729390-1205)
Enumeration Date2015-06-24
Last Update Date2021-12-14
Business Address
MICK KELLY MD
N15W28300 GOLF RD
PEWAUKEE, WI 53072-4800
Phone number: 262-303-5055
Mailing Address
MICK KELLY MD
N15W28300 GOLF RD
PEWAUKEE, WI 53072-4800
Phone number: 262-303-5055