Individual
MR. DUSTIN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0166
Mailing address
2788 VAUGHNS GROVE FAIRVW RD, PEMBROKE, KY 42266-9713
(270) 839-2226
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017091
KY
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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