Individual
KATIE ANN MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2712 GODFREY RD, GODFREY, IL 62035-3311
(618) 466-0825
Mailing address
19714 JONES RD, JERSEYVILLE, IL 62052-6823
(618) 444-8310
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2023030688
MO
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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