MEDICARE: KELLY METZ PA-C, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	20470	CA

General Provider Information

NPI Number	:	1962726778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY METZ PA-C, MPH

Provider Business Mailing Address
First Line	:	PO BOX 6730
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85246-6730
Country	:	US
Telephone Number	:	480-821-3610
Fax Number	:	480-821-3610

Provider Business Practice Location Address
First Line	:	7342 E THOMAS RD
Second Line	:	SUITE 105
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7243
Country	:	US
Telephone Number	:	480-917-6480
Fax Number	:	480-857-2667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2010
Last Update Date	:	10/08/2015

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