Individual
DERRICK E KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6517 ROYAL OAKLAND DR, INDIANAPOLIS, IN 46236-4805
(317) 657-9382
Mailing address
6517 ROYAL OAKLAND DR, INDIANAPOLIS, IN 46236-4805
(317) 657-9382
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
IN
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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