Individual
THEODORE JEROME MALECEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1008 N MULBERRY ST, ELIZABETHTOWN, KY 42701-2037
(270) 769-0865
(270) 769-0409
Mailing address
1008 N MULBERRY ST, ELIZABETHTOWN, KY 42701-2037
(270) 769-0865
(270) 769-0409
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
013519
KY
183500000X
Pharmacist
Primary
16072
IA
183500000X
Pharmacist
26091971A
IN
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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