Individual
TANISHA MARANGATTU ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14950 CLAYTON RD, CHESTERFIELD, MO 63017-7042
(636) 527-7873
Mailing address
1615 WILSON FOREST VIEW CT, CHESTERFIELD, MO 63005-4657
(331) 425-4883
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051303536
IL
183500000X
Pharmacist
Primary
2021000379
MO
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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