Individual
ALYSSA BACLIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
977 HIGHWAY 98 E, DESTIN, FL 32541-2801
(850) 650-4538
Mailing address
200 PAGE BACON RD APT 4106, MARY ESTHER, FL 32569-1767
(951) 310-8040
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
64637
FL
183500000X
Pharmacist
86147
CA
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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