Individual
MISS JESSICA RENEE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
23355 5TH AVE, FLORALA, AL 36442-3818
(334) 858-3291
(334) 858-5254
Mailing address
23355 5TH AVE, FLORALA, AL 36442-3818
(334) 858-3291
(334) 858-5254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16852
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001169
—
AL
05
—
100513800
—
FL
Enumeration date
08/10/2011
Last updated
08/10/2011
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