Provider Demographics
NPI:1497355572
Name:KELSCH, KELSEY LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:LEE
Last Name:KELSCH
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 1:490 E 200 S
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642-1434
Mailing Address - Country:US
Mailing Address - Phone:435-851-2554
Mailing Address - Fax:
Practice Address - Street 1:4627 S 900 E
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84117-4879
Practice Address - Country:US
Practice Address - Phone:801-261-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8801811-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist