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Individual

DR. MICHAEL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
3001 OAK GROVE RD, POPLAR BLUFF, MO 63901-8942
(573) 772-7169
(573) 772-7169
Mailing address
1515 N 14TH ST, POPLAR BLUFF, MO 63901-2920
(615) 972-5904

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2014031987
MO

Other

Enumeration date
09/03/2015
Last updated
09/03/2015
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