Individual
ANU CHETTICHERIL RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 S 11TH ST, LAKE WALES, FL 33853-4901
(863) 676-2564
(863) 678-1353
Mailing address
2808 VINTAGE VIEW LOOP, LAKELAND, FL 33812-4064
(863) 529-1863
(863) 678-1353
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS43535
FL
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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