Individual
AUDREY DEVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2454 S ALPINE RD, ROCKFORD, IL 61108-7882
(815) 399-5421
(815) 399-1227
Mailing address
6658 OLD HUNTERS RUN, ROCKFORD, IL 61114-7827
(815) 721-4745
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-035882
IL
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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