Individual
SANDRA MITCHELL REVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
218 SUNSET CIR, MADISON, MS 39110-7003
(601) 856-4504
Mailing address
218 SUNSET CIR, MADISON, MS 39110-7003
(601) 856-4504
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
07200
MS
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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