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Individual

TAIT MATTHEW SURBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
1145 US 31W BYP, BOWLING GREEN, KY 42101-2419
(270) 842-3339
(270) 842-4139
Mailing address
1145 US 31W BYP, BOWLING GREEN, KY 42101-2419
(270) 842-3339
(270) 842-4139

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013526
KY

Other

Enumeration date
09/26/2011
Last updated
09/26/2011
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