Individual
COREY LEE KOONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
14520 JOHN REX BLVD, RALEIGH, NC 27614-8592
(919) 556-2434
Mailing address
14520 JOHN REX BLVD, RALEIGH, NC 27614-8592
(919) 556-2434
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202212187
VA
183500000X
Pharmacist
Primary
23744
NC
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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