Individual
MR. CHARLIE WALLER COLQUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1344 22ND ST SO, ST PETERSBURG, FL 33712
(727) 821-6701
Mailing address
1344 22ND ST SO, ST PETERSBURG, FL 33712
(727) 821-6701
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS0030592
FL
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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