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Individual

GUY SIDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
555 HUNT CLUB DRIVE, COROLLA, NC 27927-0023
(252) 619-8849
Mailing address
PO BOX 23, COROLLA, NC 27927-0023
(252) 619-8849

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20251
NC
183500000X
Pharmacist
26012328A
IN

Other

Enumeration date
07/08/2011
Last updated
07/08/2011
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