Individual
MS. KELLY FRUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 SW RAMSEY AVE, GRANTS PASS, OR 97527-5535
(541) 472-7810
(541) 472-7811
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4207
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
57800
CA
363A00000X
Physician Assistant
Primary
PA214041
OR
Other
Enumeration date
05/07/2020
Last updated
06/26/2023
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