Individual
KIMBERLY SHAN HENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1480 E MAIN ST, ATTENTION: PHARMACY DEPT., WYTHEVILLE, VA 24382-3488
(276) 228-3177
(276) 228-0524
Mailing address
1480 E MAIN ST, ATTENTION: PHARMACY DEPT., WYTHEVILLE, VA 24382-3488
(276) 228-3177
(276) 228-0524
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207272
VA
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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