Individual
JAMIE RUSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1160 SHACKELFORD RD, FLORISSANT, MO 63031-4369
(314) 838-4660
Mailing address
4263 MANCHESTER AVE # F, SAINT LOUIS, MO 63110-3850
(314) 305-0207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2024010093
MO
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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