Individual
ANN MELLENCAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
450 WHITE SPAR RD, PRESCOTT, AZ 86303-4626
(928) 778-3098
(928) 713-7474
Mailing address
450 WHITE SPAR RD, PRESCOTT, AZ 86303-4626
(928) 778-3098
(928) 713-7474
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8584
AZ
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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