Individual
DR. LESLIE MAHONEY TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1010 MAIN ST S, MC KEE, KY 40447-7089
(606) 287-7104
(606) 287-3348
Mailing address
1010 MAIN ST S, MC KEE, KY 40447-7089
(606) 287-7104
(606) 287-3348
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012408
KY
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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