Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301009325 | MI |
NPI | 1003167032 |
---|---|
Provider Name | Dr. Kellee Conant |
First Address | Monroe, MI 48161-4070 |
Second Address | Monroe, MI 48161-4070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2012 |
Last Update Date | 01/10/2012 |