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Individual

MR. JERROLD D WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
153 NW PARK SQ, RUSSELLVILLE, KY 42276-1335
(270) 726-7626
(270) 726-7879
Mailing address
153 NW PARK SQ, RUSSELLVILLE, KY 42276-1335
(270) 726-7626
(270) 726-7879

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
005918
KY

Other

Enumeration date
03/15/2007
Last updated
07/08/2007
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