Individual
JESSE CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3516 DIXIE HWY, ERLANGER, KY 41018-1804
(859) 331-6878
Mailing address
814 EASTLAND DR, VILLA HILLS, KY 41017-1011
(937) 818-1988
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
019636
KY
183500000X
Pharmacist
Primary
03236972
OH
Other
Enumeration date
11/26/2020
Last updated
11/26/2020
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