Individual
MR. HILLARD KELLY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2942 ASBURY CT, MIAMISBURG, OH 45342-4433
(937) 409-6536
Mailing address
2942 ASBURY CT, MIAMISBURG, OH 45342-4433
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.168914.MEDS-IV
OH
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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