Individual
MS. MARY CATHERINE KEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
(520) 387-6036
Mailing address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
(520) 387-6036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3035
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890518
AHCCCS
AZ
05
—
890518-02
—
AZ
Enumeration date
10/19/2006
Last updated
12/27/2019
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