Individual
DR. JOHN W HUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12977 STATE ROUTE 21, DE SOTO, MO 63020-1078
(636) 586-8779
Mailing address
12977 STATE ROUTE 21, DE SOTO, MO 63020-1078
(636) 586-8779
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2008028084
MO
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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