Individual
BI KAKOU MARC ERIC DJASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6118
(928) 289-6293
Mailing address
400 W MAPLE ST, WINSLOW, AZ 86047-3447
(928) 289-6118
(928) 289-6293
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302037613
MI
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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