Individual
TAMARA PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 N ROCK RD, WICHITA, KS 67226-1309
(316) 636-5384
Mailing address
3030 N ROCK RD, WICHITA, KS 67226-1309
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13442
KS
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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