Angela Dawn Ibaviosa, R.PH.

NPI #1134611510 in Desloge, Missouri

Provider Information

NPI Number: 1134611510
Entity Type: Individual
Name: Angela Dawn Ibaviosa, R.PH.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: R.PH.
Enumeration Date: Jun 1, 2018
Last Updated: Jun 1, 2018

Practice Location

Address: PARKLAND HEALTH MART 617 N. COWLING STE G
City: Desloge
State: Missouri
ZIP Code: 63601
Phone: (573) 431-6677

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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