Individual
MR. ALFONSO DANIEL CAROLLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
10059 MARSHALL HWY, BRADSHAW, WV 24817
(304) 967-5001
Mailing address
PO BOX 751, BRADSHAW, WV 24817-0751
(304) 967-5001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3714
WV
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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