Individual
MRS. JESSICA MAE GRASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2418 BELL MANOR DR SW, HUNTSVILLE, AL 35803-3427
(256) 783-9469
Mailing address
2418 BELL MANOR DR SW, HUNTSVILLE, AL 35803-3427
(256) 783-9469
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16478
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16478
AL STATE BOARD OF PHARMACY LICENSE
AL
Enumeration date
09/16/2011
Last updated
09/16/2011
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