Individual
TISA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11588 ALLISONVILLE RD, FISHERS, IN 46038-1846
(317) 842-7773
Mailing address
11588 ALLISONVILLE RD, FISHERS, IN 46038-1846
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26018071A
IN
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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