Individual
NICKLAS NEIL WATERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
18460 N 7TH ST, PHOENIX, AZ 85022-1108
(602) 993-5781
Mailing address
18460 N 7TH ST, PHOENIX, AZ 85022-1108
(602) 993-5781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S024077
AZ
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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