Individual
KENNETH WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 GLADES RD, BEREA, KY 40403-1355
(859) 986-3103
Mailing address
2414 LAKE PARK RD, LEXINGTON, KY 40502-1342
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017112
KY
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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