Individual
MISS KELLY COLLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
120 COASTAL HORIZONS DR, SHALLOTTE, NC 28470-6094
(910) 754-4515
(910) 202-9966
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(102) 025-7099
(910) 202-9966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103680
NC
Other
Enumeration date
07/22/2005
Last updated
05/01/2018
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