Individual
DR. JUSTIN KYLE PETWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
,RPH, PHARMD
Contact information
Practice address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(866) 786-9367
Mailing address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(719) 210-9901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH033084
GA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH033084
GA
Other
Enumeration date
10/12/2021
Last updated
03/06/2024
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