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Individual

MRS. KELLY YVONNE OSBORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 468-4841
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.002812
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0106642
OH
Enumeration date
09/11/2008
Last updated
01/06/2021
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