Individual
DR. JESS SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
5690 W BROAD ST, GALLOWAY, OH 43119-8127
(614) 870-7816
Mailing address
5690 W BROAD ST, GALLOWAY, OH 43119-8127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03329330
OH
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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