Kailey Koontz, PA-C

NPI #1477146413 in Longwood, Florida

Provider Information

NPI Number: 1477146413
Entity Type: Individual
Name: Kailey Koontz, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 19, 2021
Last Updated: Feb 19, 2021

Practice Location

Address: 2180 W STATE ROAD 434 STE 1124
City: Longwood
State: Florida
ZIP Code: 32779-5008
Phone: (321) 972-1741

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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