Individual
CODY CHISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
22280 N 67TH AVE, GLENDALE, AZ 85310-5959
(623) 572-8328
Mailing address
22280 N 67TH AVE, GLENDALE, AZ 85310-5959
(623) 572-8328
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023053
AZ
Other
Enumeration date
10/06/2017
Last updated
12/17/2022
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