Individual
AMBUROSE MARIAGNANAPRAKASAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1802 HARPER RD, BECKLEY, WV 25801-3375
(304) 252-1111
Mailing address
125 GOLDFINCH DR, SHADY SPRING, WV 25918-8468
(304) 673-3969
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0008011
WV
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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