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Individual

DR. KENNETH JOSEPH MUELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1200 NORTHSIDE FORSYTH DR, NORTHSIDE HOSPITAL FORSYTH, CUMMING, GA 30041
(111) 111-1111
Mailing address
5306 DREXEL WAY, DUNWOODY, GA 30346-1945
(513) 374-5887

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03131796
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3131796
PHARMACIST LICENSE
OH
Enumeration date
08/31/2010
Last updated
11/25/2014
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