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1669885018
KELSEY BANACH
DETROIT, MI
NPI
1669885018
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MI 5201008857)
Enumeration Date
2014-06-03
Last Update Date
2014-06-03
Business Address
-- KELSEY BANACH OTR
15063 GRATIOT AVE
DETROIT, MI 48205-1332
Phone number: 313-372-4065
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Mailing Address
-- KELSEY BANACH OTR
68050 HARTWAY RD
RAY, MI 48096-1433
Phone number: 586-623-2986
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