Individual
MR. GLENN EIJI NAMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1751 HIGHWAY 95, BULLHEAD CITY, AZ 86442-6902
(928) 763-1888
Mailing address
3743 WESTCLIFF, LAUGHLIN, NV 89028
(702) 299-9393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14740
AZ
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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