Individual
MICHAEL GLENNON CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
317 6TH AVE, DES MOINES, IA 50309-4109
(502) 822-0472
Mailing address
10050 WOOD WIND CT, LOUISVILLE, KY 40223-5325
(502) 822-0472
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010236
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010236
KENTUCKY BOARD OF PHARAMCY
KY
Enumeration date
06/03/2019
Last updated
06/03/2019
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