Individual
DIVIYA SAMPATRAI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1110 LOST LAKE RD, CHIPLEY, FL 32428-4379
(850) 326-0387
Mailing address
1110 LOST LAKE RD, CHIPLEY, FL 32428-4379
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS53899
FL
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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