Individual
JUSTIN FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 772-8625
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 772-8625
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020075
KY
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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