Individual
CAROL MCKISIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
308 MAIN ST, LUMBERPORT, WV 26386-8000
(304) 584-4210
(304) 584-4771
Mailing address
308 MAIN ST, LUMBERPORT, WV 26386-8000
(304) 584-4210
(304) 584-4771
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3980
WV
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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