Individual
CHARLY ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5605 W NORTHERN AVE, GLENDALE, AZ 85301-1332
(623) 934-7926
Mailing address
5605 W NORTHERN AVE, GLENDALE, AZ 85301-1332
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S026186
AZ
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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