Individual
MATTHEW JERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1618 W MCCLAIN AVE, SCOTTSBURG, IN 47170-1161
(812) 752-5589
Mailing address
411 1/2 W MAIN ST, MADISON, IN 47250-3736
(812) 595-6848
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26029233A
IN
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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