Individual
TEDENE HALLIWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2724 W 53RD ST, FAIRWAY, KS 66205-1705
(913) 236-4983
Mailing address
2724 W 53RD ST, FAIRWAY, KS 66205-1705
(913) 236-4983
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-11759
KS
Other
Enumeration date
04/14/2013
Last updated
04/14/2013
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