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Organization

KELLAR SURGICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GABRIELLE MONTEVERGINE KELLAR CSFA (OWNER)
(954) 529-6843
Entity
Organization

Contact information

Practice address
14 GLEN WILLOW CT, GREER, SC 29650-2568
(954) 529-6843
Mailing address
14 GLEN WILLOW CT, GREER, SC 29650-2568
(954) 529-6843

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
02/22/2021
Last updated
02/22/2021
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