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Individual

JACK ROBERT VALLANDINGHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
100 N MAIN ST, SIGOURNEY, IA 52591-1414
(641) 622-3184
(641) 622-1054
Mailing address
100 N MAIN ST, SIGOURNEY, IA 52591-1414
(641) 622-3184
(641) 622-1054

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13888
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0181529
IA
01
1607324
NABP
Enumeration date
01/14/2007
Last updated
07/08/2007
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