Individual
HEPA ALY EL DOMIATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3922 WILLIS AVE, LOUISVILLE, KY 40207-4911
(502) 690-4462
Mailing address
3922 WILLIS AVE, LOUISVILLE, KY 40207-4911
(502) 408-2282
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021999
KY
Other
Enumeration date
06/15/2021
Last updated
06/30/2021
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