Individual
DR. GRANT MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2755 W PARK DR, PADUCAH, KY 42001-9058
(270) 443-0909
Mailing address
2755 W PARK DR, PADUCAH, KY 42001-9058
(270) 443-0909
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017392
KY
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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