Individual
MRS. KELLEY MAE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
2701 CHESTNUT STATION COURT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
18275 S BURR STREET, LOWELL, IN 46356
(219) 696-6750
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
31005998A
IN
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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