KELLY L SUPAN

HARRISBURG, PA
NPI1215215603
Former NameKELLY L MCCOACH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: PA  MA055024)
Enumeration Date2011-08-02
Last Update Date2020-12-19
Business Address
Ms. KELLY L SUPAN PA-C
111 S FRONT ST
HARRISBURG, PA 17101-2010
Phone number: 717-988-0000
Mailing Address
Ms. KELLY L SUPAN PA-C
409 S 2ND ST STE 2F
HARRISBURG, PA 17104-1612
Phone number: 717-988-0000
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