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Individual

KELLI KRISTINE SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
710 CENTER ST, DEPARTMENT OF PHARMACY, COLUMBUS, GA 31901-1527
(706) 571-1000
Mailing address
7461 BLACKMON RD, APT. #5108, COLUMBUS, GA 31909-8400
(785) 826-7851

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-15190
KS

Other

Enumeration date
07/30/2012
Last updated
07/30/2012
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