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1720006877
KELLY MCDERMOTT
PHILADELPHIA, PA
NPI
1720006877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: PA 508642L)
Enumeration Date
2006-07-17
Last Update Date
2007-10-24
Business Address
-- KELLY MCDERMOTT CRNA
800 SPRUCE ST
PHILADELPHIA, PA 19107-6130
Phone number: 215-829-5664
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Mailing Address
-- KELLY MCDERMOTT CRNA
804 SCOTT NIXON MEMORIAL DR
AUGUSTA, GA 30907-2464
Phone number:
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