Michael Joseph Crivellaro, PHARMD Valid NPI
Individual provider · Pharmacist · Conyers, GA
- NPI
- 1710260930
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- RPH016826 (GA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2011-09-23
- Last updated
- 2011-09-23
Practice location
1510 Milstead Ave Ne
Conyers, GA 30012-8030
(770) 785-7128