Individual
DR. KELLY MICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7255 DELMAR BLVD, SAINT LOUIS, MO 63130-4105
(269) 214-1559
Mailing address
7255 DELMAR BLVD, SAINT LOUIS, MO 63130-4105
(269) 214-1559
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2018036662
MO
Other
Enumeration date
10/25/2018
Last updated
01/16/2020
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