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Individual
MRS. MARY JO PERDUE
Active
Individual
MRS. MARY JO PERDUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12057
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12057
PHARMACIST
OH
Enumeration date
09/17/2006
Last updated
07/08/2007
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