Individual
MR. JUSTIN RUSSELL DOROTHEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
WINSLOW INDIAN HEALTHCARE CENTER (PHARMACY DEPT.), 500 INDIANA AVE, WINSLOW, AZ 86047-7403
(928) 289-6215
Mailing address
3167 N KYLE LOOP, FLAGSTAFF, AZ 86004-1837
(561) 715-4749
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS55417
FL
183500000X
Pharmacist
PSI29655
FL
Other
Enumeration date
01/15/2016
Last updated
06/12/2018
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