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Individual

JUSTIN EZENNUBIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
13845 CONLAN CIR, CHARLOTTE, NC 28277-2705
(704) 544-2092
Mailing address
6625 COW HOLLOW DR APT 2224, CHARLOTTE, NC 28226-8583
(704) 771-2436

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28998
NC
183500000X
Pharmacist
42161
SC

Other

Enumeration date
08/09/2019
Last updated
08/09/2019
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