KELLY K WIETECHA

DETROIT, MI
NPI1982642054
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MI  4704176683)
Enumeration Date2006-06-02
Last Update Date2007-07-08
Business Address
KELLY K WIETECHA CNP
HARPER PROFESSIONAL BLDG STE 1007 4160 JOHN R
DETROIT, MI 48201
Phone number: 313-745-4525
Mailing Address
KELLY K WIETECHA CNP
3800 WOODWARD AVE SUITE 702
DETROIT, MI 48201-2061
Phone number: