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Individual

ALLICIA K KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1100 N COLLEGE AVE, OPTOMETRY CLINIC, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
1100 N COLLEGE AVE, OPTOMETRY CLINIC, FAYETTEVILLE, AR 72703-1944
(479) 443-4301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
2696
AR
152W00000X
Optometrist
Primary
2783
OK

Other

Enumeration date
06/12/2013
Last updated
09/20/2016
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