Individual
MR. LARRY JAMES RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
40 HOLLY HILL DR, ELIZABETHTOWN, KY 42701-8917
(270) 737-4245
(270) 769-2887
Mailing address
40 HOLLY HILL DR, ELIZABETHTOWN, KY 42701-8917
(270) 737-4245
(270) 769-2887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
006992
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006992
PHARMACIST LICENSE NUMBER
KY
Enumeration date
10/25/2005
Last updated
07/08/2007
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