Individual
KALI SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 346-5000
Mailing address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 346-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3449-23
WI
Other
Enumeration date
10/13/2014
Last updated
03/17/2018
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