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Individual

MS. MISTY CANDACE STOFFREGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
5841 ATLANTA HWY, MONTGOMERY, AL 36117-2109
(334) 277-9676
(334) 277-9620
Mailing address
1477 N DONAHUE DR APT 801, AUBURN, AL 36830-0206
(334) 826-6975

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13657
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13657
STATE PHARMACY LICENSE
AL
Enumeration date
09/29/2006
Last updated
07/08/2007
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