Individual
SAMANTHA PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3218 OLD GLORY RD, TYLER, TX 75701
(903) 565-5777
Mailing address
3218 OLD GLORY RD, TYLER, TX 75701
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
39439
TX
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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