NPI 1548608920

James Kelly Bazelais, OTA

Practitioner Other Technician Kennett Square, PA

Practice location

Address: 600 S Broad St, Kennett Square, PA 19348-3346
Phone: (610) 924-4561
Mailing address: 944 E Johnson St, Philadelphia, PA 19138-1065

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence OP007379 (PA)

Other Technician, Other providers in Pennsylvania →

Registry record

NPI: 1548608920
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jun 2013
Record last updated: 7 Jun 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.