Individual
AMANDA RUGGERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1713 S PARK AVE, HERRIN, IL 62948-4166
(618) 942-6641
Mailing address
172 CIRCLE DR, HERRIN, IL 62948-4302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288099
IL
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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