Individual
ALISSA ANN KEILLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-7701
Mailing address
3050 E LAKE ST, COLUMBIA CITY, IN 46725-9363
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028290A
IN
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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