Individual
WILLIAM MICHAEL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3528 LONE PINE RD, MEDFORD, OR 97504-5668
(541) 973-2367
Mailing address
334 LAURELWOOD DR, JACKSONVILLE, OR 97530-9424
(541) 821-1890
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH0014997
OR
Other
Enumeration date
05/19/2019
Last updated
05/19/2019
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