Individual
KAELLY ANN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 STATE ST, SPRINGFIELD, MA 01109-3151
(413) 205-3248
Mailing address
1000 STATE ST # 55, SPRINGFIELD, MA 01109-3151
(443) 487-3351
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
09/08/2022
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