Most Relevant Information
Provider Data
| NPI Number: | 1003379561 |
| Provider Name: | KELLEY IRENE YEO |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/11/2019 |
| Last Updated: | 04/11/2019 |
Provider Practice Location
1001 LAURENCE AVE
JACKSON
MI
492022979
Practice Location Phone/Fax
| Phone: | 5177504777 |
| Fax: |
Provider Mailing Location
1001 LAURENCE AVE
JACKSON
MI
492022979
Provider Mailing Phone/Fax
| Phone: | 5177504777 |
| Fax: |