Individual
DR. KELLY S PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Mailing address
1878 W UNIVERSITY HEIGHTS DR S, FLAGSTAFF, AZ 86005-9130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS46501
FL
Other
Enumeration date
07/06/2012
Last updated
09/23/2013
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