Individual
JOHN M O'KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1020 SANSOM ST, SUITE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526
Mailing address
1020 SANSOM ST, SUITE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053209
PA
Other
Enumeration date
10/02/2007
Last updated
08/30/2016
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