Individual
DR. KELLY ANTICI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
159 FOUNTAINS BLVD STE A, MADISON, MS 39110-6344
(769) 231-1400
Mailing address
1606 HIGHLAND COLONY PARKWAY, MADISON, MS 39110
(601) 605-5928
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-13970
MS
Other
Enumeration date
08/10/2015
Last updated
11/16/2020
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