Individual
KARISSA LEANN DIETERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
5503 DELMAR BLVD, SAINT LOUIS, MO 63112-3099
(314) 200-5313
Mailing address
322 SCHOOL ST, O FALLON, MO 63366-2825
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2024030404
MO
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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