Individual
JONATHAN GRIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2431 LAKEWAY DR STE C, RUSSELL SPRINGS, KY 42642-4648
(270) 858-6400
(270) 866-7542
Mailing address
PO BOX 72, RUSSELL SPRINGS, KY 42642-0072
(270) 858-6400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015051
KY
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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