Individual
MALLORY BLISS KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 N 19TH AVE, PHOENIX, AZ 85015-5303
(602) 265-3167
Mailing address
3933 E CAMELBACK RD, PHOENIX, AZ 85018-2609
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S024800
AZ
Other
Enumeration date
08/12/2020
Last updated
05/25/2021
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