Individual
ERICK DRU DAWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2285
Mailing address
11004 N MESA DR, PEORIA, IL 61615-1107
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051289062
IL
183500000X
Pharmacist
26020883A
IN
Other
Enumeration date
08/04/2012
Last updated
08/04/2012
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