Individual
DR. ALICE BAYLES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
2300 N 14TH ST, PONCA CITY, OK 74601-1729
(580) 767-1584
(580) 767-1083
Mailing address
2300 N 14TH ST, PONCA CITY, OK 74601-1729
(580) 767-1584
(580) 767-1083
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9605
OK
Other
Enumeration date
11/13/2011
Last updated
11/13/2011
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