Individual
JERRY LEE STANKEWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1675 W SOUTH ST, OZARK, MO 65721-5152
(417) 631-7138
Mailing address
621 W BOBWHITE LN, NIXA, MO 65714-7979
(417) 631-7138
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
2006021565
MO
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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