Individual
IVAN DOBRICHKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11420 LACKLAND RD, SAINT LOUIS, MO 63146-3559
(314) 994-9900
Mailing address
134 SAINT MARYS DR, BALLWIN, MO 63021-8846
(636) 675-1540
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.300649
IL
183500000X
Pharmacist
Primary
2017026878
MO
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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