Individual
KERRY HETTINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 SCHILLER AVE, LOUISVILLE, KY 40204-1946
(502) 322-5609
Mailing address
1114 SCHILLER AVE, LOUISVILLE, KY 40204-1946
(502) 322-5609
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
019513
KY
3336C0003X
Community/Retail Pharmacy
26027404A
IN
Other
Enumeration date
09/17/2020
Last updated
09/22/2020
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