Individual
TIN TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3003 N HIGHWAY 61, MUSCATINE, IA 52761-5811
(563) 263-8312
Mailing address
3003 N HIGHWAY 61, MUSCATINE, IA 52761-5811
(563) 262-3755
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25123
IA
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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