Individual
NICOLE GREATHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
715 W MAIN ST, RUSSELLVILLE, AR 72801-3616
(479) 968-1157
Mailing address
715 W MAIN ST, RUSSELLVILLE, AR 72801-3616
(479) 968-1157
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD09858
AR
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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