Individual
KELLY L RUPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1204 QUEEN ST, POTTSTOWN, PA 19464-5832
(610) 858-2753
Mailing address
1204 QUEEN ST, POTTSTOWN, PA 19464-5832
(610) 858-2753
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN273623
PA
Other
Enumeration date
03/22/2008
Last updated
03/22/2008
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