MS. Kelly Bolam

NPI #1780303560 in Taylor, Michigan

Provider Information

NPI Number: 1780303560
Entity Type: Individual
Name: MS. Kelly Bolam
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chore Provider
Enumeration Date: Aug 24, 2022
Last Updated: Aug 24, 2022

Practice Location

Address: 6686 CAMPBELL ST
City: Taylor
State: Michigan
ZIP Code: 48180-1802
Phone: (313) 268-3348

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X	Primary

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