Most Relevant Information
Provider Data
| NPI Number: | 1003214131 |
| Provider Name: | KELLY WOLKE LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN.099066-M-IV |
Most Important Dates
| Enumeration Date: | 12/05/2014 |
| Last Updated: | 12/05/2014 |
Provider Practice Location
2421 13TH ST NW
CANTON
OH
447083116
Practice Location Phone/Fax
| Phone: | 3305882207 |
| Fax: |
Provider Mailing Location
2421 13TH ST NW
CANTON
OH
447083116
Provider Mailing Phone/Fax
| Phone: | 3305882207 |
| Fax: |