Individual
ALISA A MIATSELITSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4300 MISSOURI FLAT RD, PLACERVILLE, CA 95667-6811
(530) 621-3447
Mailing address
5145 EMERALD FELL CT, ANTELOPE, CA 95843-5940
(916) 832-1460
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
89099
CA
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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