Individual
PHILLIP RUSSELL SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
3272 WICKLOW LN, CLOVER, SC 29710
(803) 431-9208
Mailing address
3272 WICKLOW LN, CLOVER, SC 29710
(803) 431-9208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
006811
SC
183500000X
Pharmacist
PS26017
FL
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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