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Individual

CHRISTOPHER RANDAL LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D, MBA

Contact information

Practice address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
(662) 342-2906
Mailing address
35 STATELINE RD W, SOUTHAVEN, MS 38671-1705
(901) 409-1436

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P13065
MS

Other

Enumeration date
06/25/2013
Last updated
08/16/2014
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