Individual
KELLY ZALE STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
(856) 686-4306
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00227100
NJ
Other
Enumeration date
12/14/2009
Last updated
01/09/2012
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