Individual
EDITH WILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 TINEY BROWNING BLVD, PORT LAVACA, TX 77979-5215
(361) 552-3525
(361) 552-9616
Mailing address
400 TINEY BROWNING BLVD, PORT LAVACA, TX 77979-2425
(361) 552-3525
(361) 552-9616
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
45653
TX
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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