Individual
BRANDEN DEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
167 N. MAIN STREET, TUBA CITY, AZ 86045
(928) 283-2754
Mailing address
P.O BOX 600, 167 N. MAIN STREET, TUBA CITY, AZ 86045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6425
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6425
PHARMACIST LICENSE
ID
Enumeration date
12/23/2010
Last updated
12/23/2010
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