Individual
KELLI GAIL GILLISPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 S JAMES ST, GRAYLING, MI 49738-1818
(989) 348-1350
Mailing address
7406 PHEASANT RUN, GAYLORD, MI 49735-7735
(989) 350-0017
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302034626
MI
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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