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Individual

KELLY K HAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
665 E LAKE RD, CARBONDALE, IL 62901-5347
(618) 457-4900
(618) 457-4600
Mailing address
PO BOX 1268, MURPHYSBORO, IL 62966-1268
(618) 457-4900
(618) 457-4600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085378
HEALTH ALLIANCE NUMBER
IL
Enumeration date
05/25/2007
Last updated
07/09/2007
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