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1982642054
KELLY K WIETECHA
DETROIT, MI
NPI
1982642054
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: MI 4704176683)
Enumeration Date
2006-06-02
Last Update Date
2007-07-08
Business Address
KELLY K WIETECHA CNP
HARPER PROFESSIONAL BLDG STE 1007 4160 JOHN R
DETROIT, MI 48201
Phone number: 313-745-4525
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Mailing Address
KELLY K WIETECHA CNP
3800 WOODWARD AVE SUITE 702
DETROIT, MI 48201-2061
Phone number:
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