Individual
KATELYN OLIVIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6097 SISSONVILLE DR, CHARLESTON, WV 25312-9595
(304) 984-1001
Mailing address
6097 SISSONVILLE DR, CHARLESTON, WV 25312-9595
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0012765
WV
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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