Organization
INNOVATIVE MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI YACONO DO (OWNER/PHYSICIAN)
(610) 505-8350
Entity
Organization
Contact information
Practice address
400 BAILEYS RUN LN, SPRINGFIELD, PA 19064-2143
(610) 505-8350
(610) 675-1775
Mailing address
400 BAILEYS RUN LN, SPRINGFIELD, PA 19064-2143
(610) 675-1775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS014411
PA
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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