Individual
KELLY CHRISTINE MUTSAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 ALDEN ST, MEADVILLE, PA 16335-2348
(814) 724-1252
(814) 333-8871
Mailing address
640 ALDEN ST, MEADVILLE, PA 16335-2348
(814) 724-1252
(814) 333-8871
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MA052475
PA
208M00000X
Hospitalist Physician
MA052475
PA
363A00000X
Physician Assistant
MA052475
PA
363A00000X
Physician Assistant
OA002277
PA
Other
Enumeration date
05/30/2006
Last updated
06/12/2024
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