Individual
DR. KELLI RENAE POULIMENOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7441
(260) 435-7609
Mailing address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021727A
IN
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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