Individual
CHRISTINA LYNN CRUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
147 FOXTAIL DR, SAINT CHARLES, MO 63303-1703
(314) 623-7611
(636) 949-6945
Mailing address
147 FOXTAIL DRIVE, SAINT CHARLES, MO 63303
(314) 623-7611
(636) 949-6945
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043397
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043397
BOARD OF PHARMACY LISCENSE NUMBER
MO
Enumeration date
09/19/2011
Last updated
09/19/2011
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