Individual
KELLY L MAGOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1848 DAIMLER RD, ROCKFORD, IL 61112-1019
(815) 398-9100
(815) 986-6770
Mailing address
1848 DAIMLER RD, ROCKFORD, IL 61112-1019
(815) 398-9100
(815) 986-6770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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