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General NPI Number Information
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NPI Number | 1235721028
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Entity Type | Individual
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Provider Name | JONATHAN RAY LAWSON CPHT
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Gender | Male
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 275 PRESTONSBURG ST
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City | WEST LIBERTY
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State | KY
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Zip | 41472-1135
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Country | US
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Telephone | 606-743-3425
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Fax | 606-743-1936
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Provider Business Mailing Address
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Address Line | 2327 HIGHWAY 3345
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City | EZEL
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State | KY
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Zip | 41425-8967
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Country | US
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Telephone | 606-359-1967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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