Individual
SEAN MICHAEL O'BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4700 N HANLEY RD, SAINT LOUIS, MO 63134-2700
(866) 997-3688
Mailing address
4700 N HANLEY RD, SAINT LOUIS, MO 63134-2700
(866) 997-3688
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2016025435
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016025435
PHARMACIST LICENSE
MO
Enumeration date
08/14/2018
Last updated
08/14/2018
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