Individual
MOHMMAD KHOSHNEVISZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4100 S BOLGER RD, INDEPENDENCE, MO 64055-6772
(816) 350-2931
Mailing address
5128 S TIERNEY DR, INDEPENDENCE, MO 64055-6939
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
044343
MO
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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