Individual
MRS. KELLIE W WALDRIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
984 MAIN ST, SOUTHAVEN, MS 38671-1509
(662) 342-1915
(662) 393-0421
Mailing address
984 MAIN ST, SOUTHAVEN, MS 38671-1509
(662) 342-1915
(662) 393-0421
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E08849
MS
Other
Enumeration date
03/22/2013
Last updated
10/15/2014
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