Individual
CASEY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2200 TYDD ST, EUREKA, CA 95501-1284
(707) 269-7051
(707) 269-7054
Mailing address
670 9TH ST, SUITE 203, ARCATA, CA 95521-6248
(707) 826-8633
(707) 826-8638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
20196
CA
Other
Enumeration date
03/06/2009
Last updated
02/10/2017
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