Individual
JENNIFER IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HWY-163 BLDG KA-4010, KAYENTA, AZ 86033
(928) 697-4165
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4165
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20935
CO
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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