Individual
DIANE B KECKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1025 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4229
(860) 696-2400
(860) 696-2410
Mailing address
PO BOX 1086, HARTFORD MEDICAL GROUP, WILBRAHAM, MA 01095-1086
(508) 595-0531
(508) 829-5367
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001067
CT
Other
Enumeration date
12/27/2005
Last updated
01/06/2010
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