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Individual

NICHOLAS MATHIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15300 N COTTON LN, SURPRISE, AZ 85388-9613
(623) 584-8558
Mailing address
266 E SMOKE TREE LN, PRESCOTT, AZ 86301
(208) 573-5617

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023941
AZ

Other

Enumeration date
07/07/2019
Last updated
07/07/2019
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