Individual
KELLY DIAMOND MONTALVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
300 OLD FORGE LN STE 302, KENNETT SQUARE, PA 19348-1932
(484) 778-8000
Mailing address
30 FAIRHILL RD, MORTON, PA 19070-1006
(610) 945-8414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0012325
DE
363A00000X
Physician Assistant
Primary
MA063356
PA
363A00000X
Physician Assistant
OA005997
PA
Other
Enumeration date
01/26/2022
Last updated
10/20/2025
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