Individual
JESSICA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
928 GOLD HILL RD, FORT MILL, SC 29708-7947
(803) 548-7900
Mailing address
928 GOLD HILL RD, FORT MILL, SC 29708-7947
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25404
NC
183500000X
Pharmacist
PH.36291 PH
SC
183500000X
Pharmacist
RPH028805
GA
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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