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Individual

WILSON ITLIONG DATARIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
498 CHALAN PALOSYO, AGANA HEIGHTS, GU 96910-6427
(800) 214-1306
Mailing address
498 CHALAN PALOSYO, AGANA HEIGHTS, GU 96910-6427
(800) 214-1306

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PH0392
GU

Other

Enumeration date
11/21/2020
Last updated
08/28/2023
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