Individual
JERRY RICHARD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3595 N STATE ROUTE 560, URBANA, OH 43078-9367
(937) 344-0116
Mailing address
3595 N STATE ROUTE 560, URBANA, OH 43078-9367
(937) 344-0116
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22125
OH
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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