Individual
KELLY O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 SALEM TPKE STE 7, NORWICH, CT 06360-7403
(860) 859-2262
(860) 859-9819
Mailing address
111 SALEM TPKE STE 7, NORWICH, CT 06360-7403
(860) 859-2262
(860) 859-9819
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002588
CT
Other
Enumeration date
07/16/2011
Last updated
01/23/2025
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