Individual
CHARLES MICHAEL DITMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4425 19TH ST, LUBBOCK, TX 79407-2408
(806) 788-2015
Mailing address
3801 133RD ST UNIT A, LUBBOCK, TX 79423-2493
(806) 494-2746
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74229
TX
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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