Individual
MRS. KELLY MARIE PORCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(678) 230-4571
Mailing address
2795 ROXBURGH DR, ROSWELL, GA 30076-2450
(678) 230-4571
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8252
GA
Other
Enumeration date
07/27/2015
Last updated
03/21/2017
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