Provider Demographics
NPI:1467638544
Name:GOVRO, KELLY E (PA)
Entity Type:Individual
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First Name:KELLY
Middle Name:E
Last Name:GOVRO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1551 WALL ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3539
Mailing Address - Country:US
Mailing Address - Phone:636-669-2268
Mailing Address - Fax:636-669-2401
Practice Address - Street 1:1475 KISKER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-8781
Practice Address - Country:US
Practice Address - Phone:636-498-5850
Practice Address - Fax:636-498-5906
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2009-03-03
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant