Individual
SUSAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
712 HIGHWAY 371, MOOREVILLE, MS 38857-7356
(662) 840-5601
Mailing address
146 DRIVE 1375, MOOREVILLE, MS 38857-7209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-08637
MS
Other
Enumeration date
09/18/2018
Last updated
02/25/2020
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