Individual
DR. KELLY JOE VANKIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
140 CHURCH ST, SNEEDVILLE, TN 37869
(423) 733-2322
(423) 733-2140
Mailing address
5776 KAY DR, RUSSELLVILLE, TN 37860-8903
(205) 821-3000
(423) 733-2322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000022407
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790796340
PHARMACY
TN
05
—
9448755
—
TN
Enumeration date
12/12/2006
Last updated
07/09/2007
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