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1083960975
JACKIE LYN DAVID VELASCO
PLACERVILLE, CA
NPI
1083960975
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: CA 65167)
Enumeration Date
2012-07-28
Last Update Date
2012-07-28
Business Address
-- JACKIE LYN DAVID VELASCO RPH
1220 BROADWAY
PLACERVILLE, CA 95667-5806
Phone number: 530-626-5501
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Mailing Address
-- JACKIE LYN DAVID VELASCO RPH
928 PACIFIC ST
PLACERVILLE, CA 95667-5631
Phone number: 916-868-5996
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