Most Relevant Information
Provider Data
| NPI Number: | 1003303587 |
| Provider Name: | KELLY KING |
| Entity Type: | Individual |
| Taxonomy Code: | 156FX1800X |
| Specialty: | Technician/Technologist |
| License Number: | 008070 |
Most Important Dates
| Enumeration Date: | 04/19/2018 |
| Last Updated: | 04/19/2018 |
Provider Practice Location
1701 LAC DE VILLE BLVD
ROCHESTER
NY
146185630
Practice Location Phone/Fax
| Phone: | 5852712990 |
| Fax: |
Provider Mailing Location
1701 LAC DE VILLE BLVD
ROCHESTER
NY
146185630
Provider Mailing Phone/Fax
| Phone: | 5852712990 |
| Fax: |