Individual
JOSEPH IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11253 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2702
(314) 738-0235
Mailing address
11253 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2702
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2017029329
MO
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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