Individual
AMANDA BOURDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1730 E JACKSON ST, MACOMB, IL 61455-2531
(309) 833-1456
Mailing address
112 JAMES DR, MACOMB, IL 61455-3302
(847) 863-5502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051301705
IL
Other
Enumeration date
11/03/2020
Last updated
11/05/2020
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