Most Relevant Information
Provider Data
| NPI Number: | 1003403320 |
| Provider Name: | ROBERT KELLY |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/22/2020 |
| Last Updated: | 01/04/2021 |
Provider Practice Location
3707 GREEN GARDEN RD
ALIQUIPPA
PA
150011029
Practice Location Phone/Fax
| Phone: | 7246017197 |
| Fax: |
Provider Mailing Location
3707 GREEN GARDEN RD
ALIQUIPPA
PA
150011029
Provider Mailing Phone/Fax
| Phone: | 7246017197 |
| Fax: |