Individual
JACOB RUSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
25 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-6565
(928) 453-2808
Mailing address
25 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-6565
(928) 453-2808
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S018798
AZ
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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