Individual
JAMES ALLAN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
#2 COTTONWOOD RD, GLEN CARBON, IL 62034
(618) 288-4684
Mailing address
#2 COTTONWOOD RD, GLEN CARBON, IL 62034
(618) 288-4684
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.288981
IL
183500000X
Pharmacist
2003000271
MO
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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