Individual
MARY KATHERINE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87458 US HIGHWAY 278, SNEAD, AL 35952-9638
(205) 589-4392
Mailing address
5292 COUNTY HIGHWAY 39, ONEONTA, AL 35121-6144
(205) 589-4392
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S10750
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7866952
ALABAMA DRIVER'S LICENSE
AL
01
—
S10750
ALABAMA PHARMACY INTERN LICENSE
AL
Enumeration date
03/31/2015
Last updated
03/31/2015
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