Individual
COLLEEN ALYCE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2525 9TH AVE STE 2B, ALTOONA, PA 16602-2014
(814) 201-2835
Mailing address
2525 9TH AVE STE 2B, ALTOONA, PA 16602-2014
(814) 201-2835
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C07288
MD
363A00000X
Physician Assistant
Primary
MA057681
PA
363A00000X
Physician Assistant
OA003877
PA
Other
Enumeration date
07/02/2015
Last updated
12/09/2022
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