Individual
MRS. DIANNE BASFORD RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1812 HWY 77 SO, UNIT #119, LYNN HAVEN, FL 32444
(850) 271-8016
(850) 271-9379
Mailing address
516 E 2ND ST, LYNN HAVEN, FL 32444
(850) 271-8788
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH21284
FL
183500000X
Pharmacist
Primary
PS0019043
FL
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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