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1639340169
ISAAC G PROVO
NEWARK, NY
NPI
1639340169
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: NY 030985)
Enumeration Date
2008-03-12
Last Update Date
2008-03-12
Business Address
-- ISAAC G PROVO RPh
MILLER AND FINCH STREETS ATTN PHARMACY MANAGER
NEWARK, NY 14513
Phone number: 315-331-7150
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Mailing Address
-- ISAAC G PROVO RPh
1500 BROOKS AVE ATTN: PHARMACY OFFICE
ROCHESTER, NY 14624-3512
Phone number: 585-239-2020
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