Individual
DONITA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9243 E BASELINE RD, MESA, AZ 85209-8308
(480) 986-4660
Mailing address
4722 S EMERY, MESA, AZ 85212-7053
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
17107
IA
183500000X
Pharmacist
Primary
S021028
AZ
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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