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1477602530
KELLY S MACVITTIE
MADISON, WI
NPI
1477602530
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: WI 1462-23)
Enumeration Date
2007-01-09
Last Update Date
2021-02-17
Business Address
KELLY S MACVITTIE PA
600 HIGHLAND AVE
MADISON, WI 53792-0001
Phone number: 608-263-7502
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Mailing Address
KELLY S MACVITTIE PA
7974 UW HEALTH CT
MIDDLETON, WI 53562-5531
Phone number: 608-829-5485
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