Individual
EOIN C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-6299
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-6299
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4087
MA
Other
Enumeration date
11/29/2010
Last updated
05/27/2015
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