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Individual

MRS. CHRISTINE MARIE CONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
440 W GULF ATLANTIC HWY, WILDWOOD, FL 34785-7301
(352) 330-4124
Mailing address
10367 E ROO LN, PO BOX 651, FLORAL CITY, FL 34436-2957
(352) 727-0382
(352) 330-0673

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT 430
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPT 430
STATE LICENSE
FL
Enumeration date
10/13/2010
Last updated
10/13/2010
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