Individual
JUSTIN JOSEPH JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
7003 E BANNISTER RD, KANSAS CITY, MO 64134-1672
(816) 761-7715
Mailing address
1050 BERKLEY PKWY APT 253, KANSAS CITY, MO 64120-1475
(636) 699-3529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2018041600
MO
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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