Individual
MR. ALTON PAUL GRAVITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
114 E LEBANON ST, MOUNT AIRY, NC 27030-3662
(336) 786-2177
(336) 786-1556
Mailing address
114 E LEBANON ST, MOUNT AIRY, NC 27030-3662
(336) 786-2177
(336) 786-1556
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4991
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NC0865492
—
NC
Enumeration date
10/07/2010
Last updated
10/07/2010
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