Individual
MICHAEL DEAN EASTRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
361 VALLEY LN, LEBANON, KY 40033-1620
(270) 699-5827
Mailing address
361 VALLEY LN, LEBANON, KY 40033-1620
(270) 692-1801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8018
KY
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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