Individual
MALLORY SIERRA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
712 S MAIN ST, BROOKFIELD, MO 64628-2307
(660) 258-2122
Mailing address
712 S MAIN ST, BROOKFIELD, MO 64628-2307
(660) 258-2122
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2021032276
MO
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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