Kelley Widel Vitolo, CSFA
Specialist/Technologist, Other, Surgical Assistant in Roanoke, VA. Individual provider (NPI-1).
NPI number1043845712
StatusActive
Last updated in NPPESMar 3, 2020
Details
- NPI
- 1043845712
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kelley Widel Vitolo
- Credential
- CSFA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 3, 2020
- Certification date
- Mar 3, 2020
- Last updated
- Mar 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | – | VA | Yes |
Practice location
3411 Londonderry CtRoanoke, VA 24018-5059
Phone 336-327-9175
Mailing address
3411 Londonderry CtRoanoke, VA 24018-5059
Phone 336-327-9175
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