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Individual

JIRATCHAYA SURIYACHOTTAKUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6855 ALIANTE PKWY, NORTH LAS VEGAS, NV 89084-3195
(702) 642-6062
Mailing address
4185 MANGO TREE CT, LAS VEGAS, NV 89115-4125
(702) 835-2449

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
20611
NV

Other

Enumeration date
08/14/2020
Last updated
08/14/2020
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