Individual
ELENA DEMYANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4315 W BELL RD, GLENDALE, AZ 85308-3530
(623) 938-2600
Mailing address
8203 W ORAIBI DR, 2132, PEORIA, AZ 85382-4680
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S022132
AZ
Other
Enumeration date
07/31/2015
Last updated
09/02/2016
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