Khelli Wade

NPI #1245603182 in Inkster, Michigan

Provider Information

NPI Number: 1245603182
Entity Type: Individual
Name: Khelli Wade
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Oct 31, 2015
Last Updated: Oct 31, 2015

Practice Location

Address: 26554 SUNNINGDALE DR
City: Inkster
State: Michigan
ZIP Code: 48141-1920
Phone: (313) 645-4042

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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