Individual
GARY TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3533 FRANKLIN RD SW, ROANOKE, VA 24014-2201
(540) 981-9321
Mailing address
3533 FRANKLIN RD SW, ROANOKE, VA 24014-2201
(540) 981-9321
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
202011825
VA
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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