Individual
TERA ADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
978 N MAIN ST, MONTICELLO, KY 42633-1500
(606) 348-8478
(606) 348-6609
Mailing address
978 N MAIN ST, MONTICELLO, KY 42633-1500
(606) 348-8478
(606) 348-6609
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018080
KY
Other
Enumeration date
08/27/2015
Last updated
08/27/2015
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