Individual
MICHAEL S. KELLEHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(678) 819-0357
Mailing address
2085 ROSWELL RD, APT 1734, MARIETTA, GA 30062-7517
(770) 424-6893
(678) 819-0357
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004757
GA
Other
Enumeration date
04/11/2006
Last updated
07/08/2007
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