Provider Demographics
NPI:1194390435
Name:HOLT, KELSEY RICE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:RICE
Last Name:HOLT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JOE SHINGLER RD
Mailing Address - Street 2:
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837-5906
Mailing Address - Country:US
Mailing Address - Phone:229-724-3303
Mailing Address - Fax:
Practice Address - Street 1:215 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837-3407
Practice Address - Country:US
Practice Address - Phone:229-600-0524
Practice Address - Fax:229-600-0534
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist