Individual
LOTHA LEE KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 GREENHILL BLVD NW, FORT PAYNE, AL 35967-3701
(256) 845-6640
Mailing address
PO BOX 680905, FORT PAYNE, AL 35968-1610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6934
AL
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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