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1639300932
MARK KIM KELLY
FORT WAYNE, IN
NPI
1639300932
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: MI 4301095025)
Enumeration Date
2009-08-04
Last Update Date
2016-01-27
Business Address
Dr. MARK KIM KELLY M.D
3707 NEW VISION DR
FORT WAYNE, IN 46845-1702
Phone number: 248-787-4905
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Mailing Address
Dr. MARK KIM KELLY M.D
3707 NEW VISION DR
FORT WAYNE, IN 46845-1702
Phone number: 248-787-4905
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