Individual
DR. KELLY KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
23620 N 20TH DR, SUITE 12, PHOENIX, AZ 85085-0621
(602) 790-1802
Mailing address
20710 N 51ST DR, GLENDALE, AZ 85308-9369
(602) 790-1802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S017269
AZ
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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