Individual
EZRA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
939 ANGULAR ST, BURLINGTON, IA 52601-3918
(319) 753-0112
(319) 753-0113
Mailing address
939 ANGULAR ST, BURLINGTON, IA 52601-3918
(319) 753-0112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19975
IA
Other
Enumeration date
01/01/2020
Last updated
01/01/2020
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