Individual
SUSAN DIANE WEST
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
990 SPORTSMAN CLUB LN, RUSSELLVILLE, KY 42276-9256
(270) 726-9010
Mailing address
990 SPORTSMAN CLUB LN, RUSSELLVILLE, KY 42276-9256
(270) 726-9010
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
26091584A
IN
1835P1200X
Pharmacotherapy Pharmacist
Primary
7104
KY
1835P1200X
Pharmacotherapy Pharmacist
9215
TN
Other
Enumeration date
08/10/2005
Last updated
07/08/2007
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