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Individual

MR. GREGORY KEITH MANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
604 E PUSHMATAHA ST, BUTLER, AL 36904-2620
(205) 459-2990
Mailing address
2790 NEEDHAM RD, NEEDHAM, AL 36915-3001
(205) 673-2820

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10377
AL
183500000X
Pharmacist
E-07032
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10377
PHARMACIST LICENSE
AL
01
E-07032
MS PHARMACIST LICENSE
MS
Enumeration date
10/09/2006
Last updated
07/08/2007
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