DR. Russell B Mantooth, PHARMD
NPI #1053400374 in Blountville, Tennessee
Provider Information
- NPI Number
- 1053400374
- Entity Type
- Individual
- Name
- DR. Russell B Mantooth, PHARMD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pharmacist
- Credential
- PHARMD
- Enumeration Date
- Oct 12, 2006
- Last Updated
- Jul 25, 2007
Practice Location
- Address
- 420 WOODWAY DR
- City
- Blountville
- State
- Tennessee
- ZIP Code
- 37617-5558
- Phone
- (423) 323-3047
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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