Individual
KELLY F DIBBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 ALEXANDER ST STE 5000, ROCHESTER, NY 14607-4064
(585) 922-8003
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
672014
NY
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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