Individual
KELLIE A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 PENNSYLVANIA AVE, TYRONE, PA 16686-1728
(814) 684-2100
Mailing address
1400 PENNSYLVANIA AVE, TYRONE, PA 16686-1728
(814) 684-2100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063643
PA
Other
Enumeration date
06/14/2022
Last updated
03/19/2024
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