Individual
KARLIE KELLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7571 COLD HARBOR RD, MECHANICSVILLE, VA 23111-1631
(703) 965-4325
Mailing address
7571 COLD HARBOR RD, MECHANICSVILLE, VA 23111-1631
(804) 746-9055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008566
VA
Other
Enumeration date
04/07/2022
Last updated
08/29/2024
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