Individual
LAWRENCE GERARD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 O ST APT 209, COZAD, NE 69130-1077
(402) 699-8440
Mailing address
2101 O ST APT 209, COZAD, NE 69130-1077
(402) 699-8440
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10201
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10201
PHARMACY LICENSE
NE
Enumeration date
05/21/2018
Last updated
06/16/2018
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