Individual
JENNIFER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 E RAYMOND ST, INDIANAPOLIS, IN 46203-4143
(317) 784-7979
Mailing address
937 JUNCTION PL, INDIANAPOLIS, IN 46220-4278
(260) 450-2172
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022982A
IN
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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