Individual
SUSAN DIANE RILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
1235 MAIN ST, SOUTHAVEN, MS 38671-1429
(877) 864-7952
Mailing address
5713 HIGHWAY 178 E, POTTS CAMP, MS 38659-9237
(662) 544-9420
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E08347
MS
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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