Individual
KENNETH WILLARD FRATICELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 752-5111
Mailing address
PO BOX 24823, SEATTLE, WA 98124-0823
(425) 407-1500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11355
MT
Other
Enumeration date
05/02/2007
Last updated
05/12/2011
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