Kelly Rae Dallas, PA-C

NPI #1518095538 in Dover, Ohio

Provider Information

NPI Number: 1518095538
Entity Type: Individual
Name: Kelly Rae Dallas, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 1, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 897 E IRON AVE
City: Dover
State: Ohio
ZIP Code: 44622-2030
Phone: (330) 343-5555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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