Individual
JACKELLYN VERONICA REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9800 S ESTRELLA PKWY, GOODYEAR, AZ 85338-7141
(623) 255-3649
Mailing address
32359 N 129TH DR, PEORIA, AZ 85383-5079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S024314
AZ
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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