Individual
JIMMY LEE CASSITY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
222 SOLAR AVE, MONTE VISTA, CO 81144-1066
(719) 852-9894
Mailing address
PO BOX 916, ALAMOSA, CO 81101-0916
(719) 588-4377
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14302
CO
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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