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Individual
KELLY ANN DICKSON
Active
Individual
KELLY ANN DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP040138L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101483817801
—
PA
Enumeration date
02/05/2013
Last updated
02/05/2013
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