Individual
DR. QUTINA S MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19646
MD
1835P1200X
Pharmacotherapy Pharmacist
Primary
PH100000746
DC
Other
Enumeration date
08/05/2010
Last updated
09/01/2010
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