Individual
JACOB MATANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
Mailing address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020682
KY
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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