Individual
LOURIES EISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2610 W THUNDERBIRD RD, PHOENIX, AZ 85023-5948
(602) 993-9900
Mailing address
2610 W THUNDERBIRD RD, PHOENIX, AZ 85023-5948
(602) 993-9900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S022601
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D09038484
DRIVER LICENSE
AZ
Enumeration date
10/26/2017
Last updated
10/26/2017
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