Individual
DR. JEANNA SEWELL BOOTHE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3825 SULLIVAN ST, SUITE 2, MADISON, AL 35758-1740
(256) 461-6376
(256) 461-6334
Mailing address
3825 SULLIVAN ST, SUITE 2, MADISON, AL 35758-1740
(256) 461-6376
(256) 461-6334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12550
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12550
STATE LICENSE NUMBER
AL
Enumeration date
06/09/2006
Last updated
07/08/2007
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