Individual
CONNIE R DIVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
302 ENTERPRISE DR, INDEPENDENCE, IA 50644-9601
(319) 332-2906
Mailing address
302 ENTERPRISE DR, INDEPENDENCE, IA 50644-9601
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18119
IA
Other
Enumeration date
03/28/2020
Last updated
03/28/2020
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