Individual
KELLY ELIZABETH KOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4700 UNION DEPOSIT RD STE 140, HARRISBURG, PA 17111-3774
(717) 652-6605
Mailing address
4700 UNION DEPOSIT RD STE 140, HARRISBURG, PA 17111-3774
(717) 652-6605
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA061572
PA
363AM0700X
Medical Physician Assistant
OA005242
PA
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
06/08/2020
Last updated
08/07/2023
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