Justin Douglas Mckinnie

NPI #1154923084 in Mattoon, Illinois

Provider Information

NPI Number: 1154923084
Entity Type: Individual
Name: Justin Douglas Mckinnie
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 16, 2020
Last Updated: Nov 16, 2020

Practice Location

Address: 101 DETTRO DR
City: Mattoon
State: Illinois
ZIP Code: 61938-9044
Phone: (217) 258-6313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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