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Individual

DR. TREVOR VANCE RAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD.

Contact information

Practice address
908 WALLACE AVE, SUITE 105, LEITCHFIELD, KY 42754-1479
(270) 259-8500
(270) 230-8517
Mailing address
908 WALLACE AVE, SUITE 105, LEITCHFIELD, KY 42754-1479
(270) 259-8500
(270) 230-8517

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012012
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012012
KENTUCKY STATE LICENSE
KY
Enumeration date
01/03/2006
Last updated
04/25/2011
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