Individual
CLIFFORD CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
CORNERS OF ROUTE 7&12, FORT DEFIANCE, AZ 86504
(928) 729-8328
Mailing address
PO BOX 1345, FORT DEFIANCE, AZ 86504-1345
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS58414
FL
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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