Individual
KELLI NOEL PRESTAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
702 W MAIN ST, TUPELO, MS 38804-3734
(662) 840-4818
(662) 840-4816
Mailing address
702 W MAIN ST, TUPELO, MS 38804-3734
(662) 840-4818
(662) 840-4816
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-15026
MS
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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