Individual
MR. GREGORY D MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 N MCKNIGHT RD, SAINT LOUIS, MO 63132-4911
(314) 991-3402
Mailing address
7900 GANNON AVE, UNIVERSITY CITY, MO 63130-3707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29144
MO
183500000X
Pharmacist
RPH30847
CA
Other
Enumeration date
01/15/2012
Last updated
01/15/2012
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