Individual
CHRIS CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
714 PECAN AVE, PHILADELPHIA, MS 39350-3402
(601) 656-2545
Mailing address
714 PECAN AVE, PHILADELPHIA, MS 39350-3402
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8045
MS
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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