Individual
CASANDRA BONITA JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2201 W ALLEGHENY AVE, PHILADELPHIA, PA 19132-1420
(215) 223-8979
(215) 227-0932
Mailing address
2201 W ALLEGHENY AVE, PHILADELPHIA, PA 19132-1420
(215) 223-8979
(215) 227-0932
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RP029008L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679663793
NPI
PA
Enumeration date
07/30/2010
Last updated
07/30/2010
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