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Individual

MR. CHARLES ALLEN DUTCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
660 N. MAIN, TAYLOR, AZ 85939-0919
(928) 536-2044
Mailing address
660 N. MAIN, P.O. BOX 919, TAYLOR, AZ 85939-0919
(928) 536-2044

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6483
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0319865
NCPDP
AZ
01
122862
AHCCCS ID
AZ
Enumeration date
07/13/2006
Last updated
07/08/2007
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