Susannah Sport

NPI #1972115178 in Luverne, Alabama

Provider Information

NPI Number: 1972115178
Entity Type: Individual
Name: Susannah Sport
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 19, 2020
Last Updated: Aug 19, 2020

Practice Location

Address: 1440 S FOREST AVE
City: Luverne
State: Alabama
ZIP Code: 36049-7330
Phone: (334) 335-5888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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