Individual
ABIDAH OTTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9172 W UNION HILLS DR, PEORIA, AZ 85382-8177
(623) 572-0054
Mailing address
7736 W GRANADA RD, PHOENIX, AZ 85035-5066
(718) 598-2895
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023681
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S023681
PHARMACIST
AZ
Enumeration date
11/19/2018
Last updated
11/19/2018
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