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Individual

MR. JONATHAN BRETT BRASHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
521 LONE OAK RD, PADUCAH, KY 42003-4543
(270) 442-6659
(270) 442-8982
Mailing address
215 E 19TH ST, BENTON, KY 42025-1718
(270) 527-8346

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010409
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010409
STATE LICENSE NUMBER
KY
Enumeration date
09/26/2011
Last updated
09/26/2011
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