Chinagorom Ilo

NPI #1306440649 in Desoto, Texas

Provider Information

NPI Number
1306440649
Entity Type
Individual
Name
Chinagorom Ilo
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
Nov 27, 2020
Last Updated
Nov 27, 2020

Practice Location

Address
1305 W BELT LINE RD
City
Desoto
State
Texas
ZIP Code
75115-3627
Phone
(972) 223-0222

Specialties & Taxonomy Codes

Specialty
Pharmacist

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