Individual
CHERRYL GULLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 MCHENRY AVE, MODESTO, CA 95350-5439
(209) 577-8695
Mailing address
2808 CENTURY WAY, MODESTO, CA 95355-8735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH64891
CA
Other
Enumeration date
10/22/2011
Last updated
10/22/2011
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