Individual
KELLEY A KRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
3375 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 343-5114
Mailing address
3375 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 343-5114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Enumeration date
09/07/2005
Last updated
07/08/2007
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