Individual
EUGENE RUTLEDGE CHANEY IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2201 EDGEWATER DR, ORLANDO, FL 32804-5319
(407) 425-8623
Mailing address
2201 EDGEWATER DR, ORLANDO, FL 32804-5319
(407) 425-8623
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PS28866
FL
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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