Individual
JAN SUSAN VALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 E BROAD ST, STATESVILLE, NC 28625-4309
(704) 873-3553
Mailing address
1909 E BROAD ST, STATESVILLE, NC 28625-4309
(704) 873-3553
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15708
NC
Other
Enumeration date
09/02/2013
Last updated
09/02/2013
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