Individual
CHETANA MANTRI BOMMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1239 SR 436, UNIT 101, CASSELBERRY, FL 32707
(407) 679-0373
Mailing address
9856 MONTCLAIR CIR, APOPKA, FL 32703-1966
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS38713
FL
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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