Individual
MS. KELLEY WIDEL VITOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
3411 LONDONDERRY CT, ROANOKE, VA 24018-5059
(336) 327-9175
Mailing address
3411 LONDONDERRY CT, ROANOKE, VA 24018-5059
(336) 327-9175
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
VA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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