Individual
KELLEN ZAKULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44 HAMPSTEAD RD, JAMAICA PLAIN, MA 02130-3911
(218) 208-8134
Mailing address
44 HAMPSTEAD RD, JAMAICA PLAIN, MA 02130-3911
(218) 208-8134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8601
MA
363AM0700X
Medical Physician Assistant
PA8601
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/12/2021
Last updated
03/15/2022
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