Individual
KENNETH PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3404 WAKE FOREST RD, STE 201, RALEIGH, NC 27609-7341
(919) 256-1511
(919) 256-1530
Mailing address
3404 WAKE FOREST RD, STE 201, RALEIGH, NC 27609-7341
(919) 256-1511
(919) 256-1530
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
102579
NC
Other
Enumeration date
05/26/2006
Last updated
08/12/2010
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