Individual
MARCUS ANTHONY AGUALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1750 E BROADWAY RD, TEMPE, AZ 85282-1612
(480) 557-0970
Mailing address
1044 MAGIC MOUNTAIN DR, CLIFTON, AZ 85533-8107
(928) 965-5588
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S027111
AZ
Other
Enumeration date
08/06/2024
Last updated
08/07/2024
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