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Individual

MR. KERRY SHANE HOGAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHARM D.

Contact information

Practice address
1131 N QUINCY AVE, OTTUMWA, IA 52501-3857
(641) 683-3814
(641) 682-3687
Mailing address
132 CARTER AVE, OTTUMWA, IA 52501-1201
(641) 682-3313

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19763
IA

Other

Enumeration date
11/23/2005
Last updated
07/08/2007
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