Individual
SHELLY DORTCH OSWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2461 5TH ST N, COLUMBUS, MS 39705-2005
(662) 327-0079
Mailing address
33 LAKEOVER DR W, COLUMBUS, MS 39702-9709
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E08639
MS
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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