Individual
DR. LARRY W ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1250 S HIGHWAY 27, SOMERSET, KY 42501-3525
(606) 676-0485
(160) 667-6962
Mailing address
187 LAKE FOREST DR., SOMERSET, KY 42503
(606) 875-3322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013346
KY
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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