Individual
COURTNEY WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 MAIN ST, TUBA CITY, AZ 86045-8604
(866) 976-5941
Mailing address
55 SAN CARLO CT, DANVILLE, CA 94526-3066
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
81512
CA
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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