Individual
DR. JUSTICE DOMONIC BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(865) 278-0692
Mailing address
577 FULTON RD, HARROGATE, TN 37752-3129
(865) 278-0692
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
024423
KY
183500000X
Pharmacist
48212
TN
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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