Individual
DR. JEFFERSON FREDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1619
Mailing address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6618
NM
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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