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1831334150
KELLY DAWN BLISS
BELLEVILLE, IL
NPI
1831334150
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085003451)
Enumeration Date
2008-12-16
Last Update Date
2017-03-15
Business Address
-- KELLY DAWN BLISS PA
4500 MEMORIAL DR
BELLEVILLE, IL 62226-5360
Phone number: 618-257-6420
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Mailing Address
-- KELLY DAWN BLISS PA
2100 POWELL ST STE 900
EMERYVILLE, CA 94608-1844
Phone number: 510-851-7423
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