Individual
MR. TRAVIS G MAINOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
3701 NATIONAL RD E, RICHMOND, IN 47374-3614
(765) 935-2074
(765) 962-3049
Mailing address
6420 BETHEL RD, FOUNTAIN CITY, IN 47341-9791
(513) 255-0484
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021257A
IN
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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