Individual
AMANDA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9901 MANCHESTER RD, SAINT LOUIS, MO 63122-1915
(314) 919-0611
Mailing address
9901 MANCHESTER RD, SAINT LOUIS, MO 63122-1915
(314) 919-0611
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2009000314
MO
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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