Individual
DR. SAMUEL ROBERT KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
410 GRAND VALLEY BLVD, MARTINSVILLE, IN 46151-6123
(765) 349-1138
(765) 349-2887
Mailing address
605 E AUDUBON DR, BLOOMINGTON, IN 47408-9730
(812) 606-6871
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021235A
IN
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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