Individual
ELLIOT DEISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
1201 W 136TH ST, KANSAS CITY, MO 64145-1647
(816) 412-0109
Mailing address
1201 W 136TH ST, KANSAS CITY, MO 64145-1647
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2020029137
MO
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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