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Individual

MR. WILLARD OLIVER YOUNGBLOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
800 NOBLE ST, ANNISTON, AL 36201-5626
(256) 236-2271
Mailing address
1306 7TH AVE NE, JACKSONVILLE, AL 36265
(256) 782-9873

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7940
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7940
PHARMACIST LICENSE
AL
Enumeration date
01/13/2012
Last updated
01/13/2012
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