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Individual
KELLY JO VOLLMER
Active
Individual
KELLY JO VOLLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011880
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03074128
—
NY
Enumeration date
07/25/2007
Last updated
11/01/2017
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