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1194898544
JEFFREY KELLY
SCRANTON, PA
NPI
1194898544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: PA ma052458)
Enumeration Date
2006-11-15
Last Update Date
2007-07-08
Business Address
-- JEFFREY KELLY
1800 MULBERRY ST
SCRANTON, PA 18510-2369
Phone number: 570-969-8128
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Mailing Address
-- JEFFREY KELLY
PO BOX 319
DUNMORE, PA 18512-0319
Phone number: 570-558-2630
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