Individual
MICHAEL MCKNATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1235 STATELINE RD W, SOUTHAVEN, MS 38671-1429
(187) 786-4795
(662) 342-9026
Mailing address
1235 STATELINE RD W, SOUTHAVEN, MS 38671-1429
(187) 786-4795
(662) 342-9026
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8255
MS
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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