Individual
JACOB SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 W HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-4911
Mailing address
5260 TRAIL END RD, LAKESIDE, AZ 85929-5723
(520) 869-0545
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S025338
AZ
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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