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1134523020
KELLI VAN WYK
JENISON, MI
NPI
1134523020
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MI 7101004541)
Enumeration Date
2014-10-21
Last Update Date
2014-10-21
Business Address
-- KELLI VAN WYK
7086 8TH AVE
JENISON, MI 49428-9352
Phone number: 616-667-9551
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Mailing Address
-- KELLI VAN WYK
1430 JENNINGS ST SE
GRAND RAPIDS, MI 49507-3721
Phone number:
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