Individual
KEVIN MICHAEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
27A CENTENNIAL DR, PEABODY, MA 01960-7901
(978) 532-2428
Mailing address
57 ARGILLA RD, IPSWICH, MA 01938-2603
(978) 766-5696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1203
NE
363A00000X
Physician Assistant
Primary
232
MA
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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