Provider Demographics
NPI:1720372568
Name:MOWELL, KELLY A (DVM)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:A
Last Name:MOWELL
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:N4415A US HIGHWAY 45
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:WI
Mailing Address - Zip Code:53019-1220
Mailing Address - Country:US
Mailing Address - Phone:920-477-3003
Mailing Address - Fax:920-477-4001
Practice Address - Street 1:161 N ROLLING MEADOWS DR
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-9482
Practice Address - Country:US
Practice Address - Phone:920-933-3880
Practice Address - Fax:920-933-3883
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4059-50174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian