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Individual

KELSEY MARIAH MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
100 KETTERING WAY STE 100, FRANKLIN, OH 45005-1155
(937) 746-8357
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6308

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2602
SC
363A00000X
Physician Assistant
2883
TN
363A00000X
Physician Assistant
Primary
50.008581RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2736PA
SC
Enumeration date
11/03/2015
Last updated
11/19/2024
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