W. DALE KECKLEY

FARMINGTON, CT
NPI1336126259
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: CT  001065)
Enumeration Date2005-12-30
Last Update Date2012-09-11
Business Address
-- W. DALE KECKLEY PA
263 FARMINGTON AVE GENERAL SURGERY
FARMINGTON, CT 06030-6227
Phone number: 860-679-8080
Mailing Address
-- W. DALE KECKLEY PA
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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