Individual
THOMAS GRAVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
20 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-5401
(859) 301-9025
Mailing address
3035 WINTERBOURNE RD, EDGEWOOD, KY 41017-9683
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008717
KY
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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