Individual
ABRAHAM ANTONE VIERTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
819 W MAIN ST, JACKSONVILLE, AR 72076-4435
(501) 241-0225
Mailing address
819 W MAIN ST, JACKSONVILLE, AR 72076-4435
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD15575
AR
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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