Individual
RAYCHELLE IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
4373 NORTHCREEK BLVD, NORTHPORT, AL 35473-2171
(800) 489-3636
Mailing address
3611 RICE MINE RD NE LOT 209, TUSCALOOSA, AL 35406-1551
(205) 219-4561
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T45310
AL
Other
Enumeration date
11/07/2020
Last updated
11/07/2020
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