Individual
KELLIE A LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
403 HIGHWAY 90, WAVELAND, MS 39576-2507
(228) 467-9247
(228) 467-4207
Mailing address
403 HIGHWAY 90, WAVELAND, MS 39576-2507
(228) 467-9247
(228) 467-4207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-010294
MS
183500000X
Pharmacist
PST.018287
LA
Other
Enumeration date
03/14/2011
Last updated
03/14/2011
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