Individual
DR. DIANE ETONDE IKOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
10445 DIXIE HWY, LOUISVILLE, KY 40272-3953
(502) 935-3265
(502) 935-3423
Mailing address
418 BERMUDA LN, LOUISVILLE, KY 40213-3332
(270) 519-4985
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
022162
KY
Other
Enumeration date
07/25/2021
Last updated
04/30/2023
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