Individual
WALTON FRANK THERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
915 HILL ST, ELLISVILLE, MS 39437-2419
(601) 477-3573
Mailing address
915 HILL ST, ELLISVILLE, MS 39437-2419
(601) 477-3573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E6418
MS
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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