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Individual

MR. JOEL CHANDLER LISTA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
3725 RIVERS AVE, SUITE 2, N CHARLESTON, SC 29405-7038
(843) 745-8650
(843) 554-5453
Mailing address
523 SCHOONER RD, CHARLESTON, SC 29412-8934
(843) 745-8650
(843) 554-5453

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5947
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5947
RPH
SC
Enumeration date
05/19/2006
Last updated
07/08/2007
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