Individual
PAUL J KASSEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
650 JOEL DR, ATTN: DEPARTMENT OF PHARMACY, FORT CAMPBELL, KY 42223-5318
(270) 956-0193
Mailing address
650 JOEL DR, ATTN: DEPARTMENT OF PHARMACY, FORT CAMPBELL, KY 42223-5318
(270) 956-0193
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
14582
AL
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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