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Individual

JEFFREY RUSSELL STANSBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1850 W. RIO SALADO PARKWAY, SUITE 211, TEMPE, AZ 85281
(916) 926-5182
Mailing address
10969 WOOLWICH WAY, MATHER, CA 95655
(916) 792-1587

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
03237372
OH
183500000X
Pharmacist
051299865
IL
183500000X
Pharmacist
Primary
65726
CA
183500000X
Pharmacist
RPH-0015102
OR
183500000X
Pharmacist
S024817
AZ

Other

Enumeration date
01/21/2021
Last updated
01/21/2021
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