Individual
TIMOTHY WYATT QUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
437 JAMES E HANNAH DR, SOUTH SHORE, KY 41175-9600
(606) 932-3614
Mailing address
2216 OHIO RIVER RD, GREENUP, KY 41144-6603
(606) 923-9155
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008916
KY
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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