Individual
KELLY BALYEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 NORTH WAYNE STREET, ANGOLA, IN 46703
(260) 665-5560
(260) 665-5569
Mailing address
2012 NORTH WAYNE STREET, WALGREENS PHARMACY, ANGOLA, IN 46703
(260) 665-5560
(260) 665-5569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26023420A
IN
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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