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Individual

MR. JAMES WILLIAM FLETCHER IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
27289 CAPROCK WAY, MORENO VALLEY, CA 92555-4582
(815) 616-9012
Mailing address
27289 CAPROCK WAY, MORENO VALLEY, CA 92555-4582
(815) 616-9012

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049-185630
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
049.185630
ILLINOIS PHARMACY TECHNICIAN LICENSE
IL
Enumeration date
10/06/2008
Last updated
08/19/2021
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