Individual
JENNY CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13982 W WADDELL RD, SURPRISE, AZ 85379-8737
(623) 537-9663
Mailing address
13982 W WADDELL RD, SURPRISE, AZ 85379-8737
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019177
AZ
Other
Enumeration date
08/16/2012
Last updated
10/25/2013
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