Individual
MARYAM TAVAKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 W VALENCIA RD, TUCSON, AZ 85746-6021
(503) 573-3167
Mailing address
1650 W VALENCIA RD, TUCSON, AZ 85746-6021
(503) 573-3167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019690
AZ
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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