Individual
CHRISTOPHER PATRICK KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
202 LARRY JOE HARLESS DR., GILBERT, WV 25621-1842
(304) 664-6270
(304) 664-6272
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01578
WV
363A00000X
Physician Assistant
Primary
2800
WV
363A00000X
Physician Assistant
601
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810025900
—
WV
Enumeration date
09/08/2011
Last updated
04/03/2017
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