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Individual

JULIAN SOUTHERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
3269 STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-0618
Mailing address
996 E STORM CLOUD DR, KINGMAN, AZ 86409-1103
(928) 757-9734
(928) 692-4141

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10406
AZ

Other

Enumeration date
12/23/2006
Last updated
07/08/2007
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