Individual
JAKE JAMES WHITWAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1514 E FLORENCE BLVD, CASA GRANDE, AZ 85122-4741
(520) 836-2787
Mailing address
41848 W BARCELONA DR, MARICOPA, AZ 85138-3663
(760) 805-1626
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S024304
AZ
Other
Enumeration date
11/28/2019
Last updated
11/28/2019
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