Individual
AIDAN ROBERT SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
8333 ROCKSIDE RD, CLEVELAND, OH 44125-6134
(216) 369-2200
(216) 369-2201
Mailing address
1499 N FORBES RD, LEXINGTON, KY 40511-2013
(859) 314-5044
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT00354743
KY
Other
Enumeration date
04/18/2021
Last updated
09/13/2024
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