Individual
MRS. KATHLEEN MELLOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2 W 42ND ST, SUITE 120, SCOTTSBLUFF, NE 69361-0617
(308) 635-1414
(308) 635-1913
Mailing address
2 W 42ND ST, SUITE 120, SCOTTSBLUFF, NE 69361-0617
(308) 635-1414
(308) 635-1913
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1605
NE
Other
Enumeration date
09/25/2006
Last updated
05/31/2012
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