Individual
MRS. JENNIFER LYNN KELLEMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
849 PACER DR NW, CORYDON, IN 47112-2145
(812) 738-2278
Mailing address
12270 SAINT LOUIS ST, LEOPOLD, IN 47551-8950
(812) 719-8219
(812) 738-7116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003361A
IN
152W00000X
Optometrist
18003361B
IN
Other
Enumeration date
11/29/2006
Last updated
10/23/2020
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