Individual
MRS. JACQUELYN KATHLEEN RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
1010 W COLUMBIA ST, FARMINGTON, MO 63640-2902
(573) 218-6754
(573) 218-6762
Mailing address
1010 W COLUMBIA ST, FARMINGTON, MO 63640-2902
(573) 218-6754
(573) 218-6762
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2012025389
MO
Other
Enumeration date
12/27/2013
Last updated
12/27/2013
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