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Individual

ALLEN ANTHONY MCCANLESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
285 DOVER POTTERY DR, SEAGROVE, NC 27341-7311
(910) 464-1019
Mailing address
285 DOVER POTTERY DR, SEAGROVE, NC 27341-7311
(910) 464-1019

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
05842
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05482
BOARD OF PHARMACY LICENSE NUMBER
NC
Enumeration date
08/22/2011
Last updated
08/22/2011
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