Individual
MRS. ELISHA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1004 BIG BEAR HWY, BENTON, KY 42025
(270) 703-1169
Mailing address
1004 BIG BEAR HWY, BENTON, KY 42025
(270) 703-1169
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013283
KY
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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