Individual
MISS CARLY ANN KINDBOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 CIVIC CENTER BLVD., EAST PAVILION, 2ND FLOOR, PHILADELPHIA, PA 19104-4306
(215) 615-4949
(215) 615-0829
Mailing address
3400 SPRUCE ST, 9 GATES, PHILADELPHIA, PA 19104-4238
(215) 662-7355
(215) 349-8444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA058356
PA
Other
Enumeration date
09/11/2015
Last updated
12/09/2022
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