Individual
MRS. KELLY ANN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
10 N MAIN ST, CHARLTON, MA 01507-1590
(508) 248-1770
Mailing address
1 DENSLOW RD, EAST LONGMEADOW, MA 01028-3104
(413) 565-1501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MA
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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