Individual
KELSEY VAN GORKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 W 7TH ST, 119/LR, LITTLE ROCK, AR 72205-5446
(830) 313-2108
Mailing address
4300 W 7TH ST, 119/LR, LITTLE ROCK, AR 72205-5446
(830) 313-2108
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
57432
TX
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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