Individual
MIKE CRUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 OAK GROVE RD, POPLAR BLUFF, MO 63901-8942
(573) 772-7169
Mailing address
3001 OAK GROVE RD, POPLAR BLUFF, MO 63901-8942
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011026566
MO
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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