Individual
DORIS KOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E MAIN ST, RUSSELLVILLE, AR 72801-5319
(479) 967-1573
Mailing address
1100 E MAIN ST, RUSSELLVILLE, AR 72801-5319
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD12119
AR
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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