Individual
GRACE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 WEST WASHINGTON AVENUE, AVA, MO 65608
(417) 683-4127
Mailing address
124 WEST WASHINGTON AVE., AVA, MO 65608
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011021862
MO
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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