Individual
KELLY S MACVITTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-7502
(608) 263-7652
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 829-5485
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1462-23
WI
Other
Enumeration date
01/09/2007
Last updated
02/17/2021
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