Individual
DR. BRIAN THOMAS KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1380 S APPOMATTOX AVE, REPUBLIC, MO 65738-7802
(417) 258-0087
Mailing address
1380 S APPOMATTOX AVE, REPUBLIC, MO 65738-7802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011027023
MO
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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