Individual
AMANDA MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1201 E STATE ST, ROCKFORD, IL 61104-2212
(815) 962-2812
(815) 962-3259
Mailing address
1201 E STATE ST, ROCKFORD, IL 61104-2212
(815) 962-2812
(815) 962-3259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.293202
IL
183500000X
Pharmacist
17256
NC
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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