KELLY LEIGH MACK

PRINCE FREDERICK, MD
NPI1396813960
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: TX  PA07662)
Additional Taxonomies363AM0700X Physician Assistant, Medical
(Licence: CA  PA18061)
Enumeration Date2006-12-01
Last Update Date2019-08-13
Business Address
Mrs. KELLY LEIGH MACK PA-C
995 N. PRINCE FREDERICK BLVD SUITE 204
PRINCE FREDERICK, MD 20678
Phone number: 410-535-5855
Mailing Address
Mrs. KELLY LEIGH MACK PA-C
4505 KINGWOOD DR STE 185
KINGWOOD, TX 77345-2618
Phone number: 281-747-5533