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Individual

DR. EVER JACK FUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
930 NE MAIN ST, SIMPSONVILLE, SC 29681-2010
(864) 963-2573
Mailing address
930 NE MAIN ST, SIMPSONVILLE, SC 29681-2010

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37295
SC

Other

Enumeration date
08/04/2017
Last updated
08/04/2017
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