Individual
JUANA DE LOS ANGELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
15300 N COTTON LN, SURPRISE, AZ 85388-9613
(623) 584-8558
Mailing address
PO BOX 673, EL MIRAGE, AZ 85335-0673
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S025997
AZ
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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