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Individual

DR. SHANE MCMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1217 S MAIN ST, MARYVILLE, MO 64468-2603
(660) 582-2199
(660) 582-2456
Mailing address
1217 S MAIN ST, MARYVILLE, MO 64468-2603
(660) 582-2199
(660) 582-2456

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011027356
MO

Other

Enumeration date
09/19/2014
Last updated
09/19/2014
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