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1356637524
DOUGLAS EDWARD GARDNER
SOUTHAVEN, MS
NPI
1356637524
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: MS E-6112)
Enumeration Date
2011-06-25
Last Update Date
2011-06-25
Business Address
DOUGLAS EDWARD GARDNER RPH
465 STATELINE RD W
SOUTHAVEN, MS 38671-1611
Phone number: 662-393-3426
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Mailing Address
DOUGLAS EDWARD GARDNER RPH
465 STATELINE RD W
SOUTHAVEN, MS 38671-1611
Phone number: 662-393-3426
Copy
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