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Individual

DR. STACIE BROOKE DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
123 S JACKSON ST, GROVE HILL, AL 36451-3007
(251) 275-3669
(251) 275-8190
Mailing address
PO BOX 790, GROVE HILL, AL 36451-0790
(251) 275-3669
(251) 275-8190

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17836
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17836
STATE OF ALABAMA PHARMACY LICENSE
AL
Enumeration date
08/05/2016
Last updated
08/05/2016
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