Individual
DR. NICKELLE ANNE KELLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
300 S PARK RD STE 300, HOLLYWOOD, FL 33021-8353
(954) 925-2740
(954) 923-8379
Mailing address
300 S PARK RD STE 300, HOLLYWOOD, FL 33021-8353
(954) 925-2740
(954) 923-8379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3480
FL
Other
Enumeration date
06/23/2009
Last updated
06/02/2020
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