Individual
DR. JUSTIN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
US ROUTE 119 HOLDEN ROAD, MOUNT GAY, WV 25637-1264
(304) 239-2380
(304) 239-2384
Mailing address
PO BOX 1264, MOUNT GAY, WV 25637-1264
(304) 239-2380
(304) 239-2384
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
014618
KY
183500000X
Pharmacist
034037
TN
183500000X
Pharmacist
46090
FL
183500000X
Pharmacist
Primary
7030
WV
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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