Individual
MICHAEL JOHN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 TROWBRIDGE RD, SUITE 100, BOURNE, MA 02532-3660
(508) 778-4777
Mailing address
297 NORTH ST STE 221, HYANNIS, MA 02601-5133
(508) 862-7777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0000737
DE
363A00000X
Physician Assistant
Primary
PA4403
MA
Other
Enumeration date
12/01/2011
Last updated
06/18/2019
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