Individual
TIFFANY PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1117 MAIN ST, IMPERIAL, MO 63052-2323
(636) 464-1100
Mailing address
1117 MAIN ST, IMPERIAL, MO 63052-2323
(636) 464-1100
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
15203
MO
183700000X
Pharmacy Technician
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
About Stedi
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