Individual
MRS. IVY JACKIE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2112
(252) 399-2136
Mailing address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2112
(252) 399-2136
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
28514
NC
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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