Individual
THOMAS J SHACKLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3600 FERN VALLEY RD, LOUISVILLE, KY 40219
(502) 964-7114
(502) 964-6156
Mailing address
3600 FERN VALLEY RD, LOUISVILLE, KY 40219
(502) 964-7114
(502) 964-6156
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009189
KY
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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