Provider Demographics
NPI:1649540469
Name:SALANCE, KAREN SUE (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:SALANCE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1022
Mailing Address - Country:US
Mailing Address - Phone:740-441-0175
Mailing Address - Fax:
Practice Address - Street 1:204 2ND AVE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1022
Practice Address - Country:US
Practice Address - Phone:740-441-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03317248183500000X
WVRP0004559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist