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1982042198
KENNERH PROVINE COLLINS
MERIDIAN, MS
NPI
1982042198
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1835P1200X Pharmacist, Pharmacotherapy
(Licence: MS e7052)
Enumeration Date
2013-06-10
Last Update Date
2013-06-10
Business Address
Mr. KENNERH PROVINE COLLINS bs
2917 56TH COURT
MERIDIAN, MS 39305
Phone number: 601-604-9114
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Mailing Address
Mr. KENNERH PROVINE COLLINS bs
2917 56TH COURT
MERIDIAN, MS 39305
Phone number: 601-604-9114
Copy
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