Individual
KALIE NICOLE FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-1447
(740) 474-2126
Mailing address
PO BOX 77, LITHOPOLIS, OH 43136-0077
(614) 493-6291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008418RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/18/2023
Last updated
10/09/2023
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