Individual
KELLY JO PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5310 W THUNDERBIRD RD, SUITE 301, GLENDALE, AZ 85306-4706
(602) 865-4011
(602) 412-7475
Mailing address
5310 W THUNDERBIRD RD, SUITE 301, GLENDALE, AZ 85306-4706
(602) 865-4011
(602) 412-7475
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5291
AZ
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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