Individual
IVY DONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1637 N TREKELL RD, CASA GRANDE, AZ 85122-2740
(520) 421-4499
(520) 421-7110
Mailing address
5163 W WHITTEN ST, CHANDLER, AZ 85226-4525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S020121
AZ
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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