Individual
WINGLOCK JOHNSON NG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 HIGHWAY 15, WHITESBURG, KY 41858-7413
(606) 632-1936
Mailing address
124 RIVERSIDE DR, WHITESBURG, KY 41858-7600
(606) 633-7009
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010195
KY
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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