Individual
MAXIM RENNIE PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2415 E UNION HILLS DR, PHOENIX, AZ 85050-3146
(602) 867-0561
Mailing address
28515 N NORTH VALLEY PKWY APT 1129, PHOENIX, AZ 85085-5411
(480) 569-5174
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S025716
AZ
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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