Individual
THO PROFERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
255 16TH ST SW, SIOUX CENTER, IA 51250-2959
(712) 722-2326
(712) 722-2589
Mailing address
719 E 13TH ST, SOUTH SIOUX CITY, NE 68776-2427
(712) 389-0932
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16241
NE
183500000X
Pharmacist
23457
IA
Other
Enumeration date
12/04/2019
Last updated
12/30/2019
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