Individual
TYLER KELLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
724 W STADIUM BLVD, JEFFERSON CITY, MO 65109-4772
(573) 635-8384
Mailing address
724 W STADIUM BLVD, JEFFERSON CITY, MO 65109-4772
(573) 635-8384
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2005016326
MO
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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