KELLY ANN BEVILAQUA-TRACY

SCRANTON, PA
NPI1114179637
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: PA  MA053585)
Enumeration Date2008-10-15
Last Update Date2020-12-30
Business Address
KELLY ANN BEVILAQUA-TRACY PA
1800 MULBERRY ST
SCRANTON, PA 18510-2369
Phone number: 570-703-4830
Mailing Address
KELLY ANN BEVILAQUA-TRACY PA
100 N ACADEMY AVE
DANVILLE, PA 17822-4903
Phone number: 570-271-6144