KELLY JOAN KOUSTAS

DETROIT, MI
NPI1528437597
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MI  4703110676)
Enumeration Date2015-09-21
Last Update Date2015-09-21
Business Address
-- KELLY JOAN KOUSTAS
751 E GRAND BLVD
DETROIT, MI 48207-2529
Phone number: 313-995-0523
Mailing Address
-- KELLY JOAN KOUSTAS
24616 NOTRE DAME
DEARBORN, MI 48124
Phone number: 313-995-0523