Individual
SUE ELLEN DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
12862 STATE ROUTE 21, DE SOTO, MO 63020-1096
(636) 586-9666
(636) 586-7700
Mailing address
1110 JACOB LN, FESTUS, MO 63028-3481
(636) 937-9717
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044326
MO
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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