Individual
JUSTIN KICKLITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
136 E BROADWAY, NEWPORT, TN 37821-2323
(423) 720-9777
(423) 720-9778
Mailing address
136 E BROADWAY, NEWPORT, TN 37821-2323
(423) 720-9777
(423) 720-9778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000029500
TN
Other
Enumeration date
01/08/2010
Last updated
03/09/2021
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