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1366951253
KELSEY MARIE GLIDEWELL
COLTON, CA
NPI
1366951253
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CA 54919)
Enumeration Date
2017-09-24
Last Update Date
2021-12-08
Business Address
KELSEY MARIE GLIDEWELL PA-C
400 N PEPPER AVE
COLTON, CA 92324-1801
Phone number: 909-580-6170
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Mailing Address
KELSEY MARIE GLIDEWELL PA-C
PHR GROUP PROVIDER ENROLLMENT UNIT 393 E WALNUT ST FL 3
PASADENA, CA 91188-0001
Phone number: 877-608-0044
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