Individual
TERESA L MUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
9 N STATE ST, NORTH VERNON, IN 47265-1723
(812) 346-4834
(812) 346-7058
Mailing address
940 DRIFTWOOD AVE, COLUMBUS, IN 47203-1083
(812) 378-9934
(812) 346-7058
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016862A
IN
183500000X
Pharmacist
PH19932
MA
183500000X
Pharmacist
PS22922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26016862A
PHARMACIST STATE LISCENSE
IN
Enumeration date
09/05/2011
Last updated
09/05/2011
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