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Individual

ELLEN MARIE KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3373 COMMERCE PKWY STE 2, WOOSTER, OH 44691-7130
(330) 804-9712
(330) 804-9811
Mailing address
3373 COMMERCE PKWY STE 2, WOOSTER, OH 44691-7130
(330) 804-9712
(330) 804-9811

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005148RX
OH
363AS0400X
Surgical Physician Assistant
OH

Other

Enumeration date
05/25/2017
Last updated
02/03/2021
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