Individual
KYLENE ELIZABETH KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 ROUTE 70 STE 100, MEDFORD, NJ 08055-9501
(856) 630-7468
Mailing address
131 ROUTE 70 STE 100, MEDFORD, NJ 08055-9501
(856) 630-7468
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00661100
NJ
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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