Individual
WALTER BALLARD BEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12611 TAYLORSVILLE RD, LOUISVILLE, KY 40299-4452
(502) 261-7042
(502) 266-2616
Mailing address
17006 PERSIMMON WOOD TRL, FISHERVILLE, KY 40023-9706
(502) 424-3448
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9049
KY
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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