Individual
MRS. ALAINA DANIELE WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1436 STATE ROAD 121 SOUTH, MACCLENNY, FL 32063-5565
(904) 259-5824
(904) 259-5275
Mailing address
732 MILTONDALE RD, MACCLENNY, FL 32063-5565
(904) 655-7671
(904) 259-5275
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
420101071242693
FL
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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