# KELLAR SURGICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144814138
- **Authorized official:** MRS. GABRIELLE MONTEVERGINE KELLAR CSFA (OWNER)
- **Authorized official phone:** (954) 529-6843

## Contact information

- **Practice address:** 14 GLEN WILLOW CT, GREER, SC 29650-2568
- **Practice address phone:** (954) 529-6843
- **Mailing address:** 14 GLEN WILLOW CT, GREER, SC 29650-2568
- **Mailing address phone:** (954) 529-6843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 02/22/2021
- **Last updated:** 02/22/2021