Individual
MS. KELSEY ANN LEEDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 S RIVER ST, PLAINS, PA 18705-1143
(570) 821-1100
Mailing address
110 PINECREST AVE, DALLAS, PA 18612-1623
(570) 550-1428
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA056395
PA
Other
Enumeration date
10/04/2013
Last updated
05/01/2018
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