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Individual

KELLY RENEE SUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
334 THOMAS MORE PKWY, CRESTVIEW HILLS, KY 41017-3464
(593) 410-2888
(859) 341-7482
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TP658
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/23/2017
Last updated
11/09/2020
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