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Individual

KATHERINE MICHELLE DERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
247 PHEASANT POINT BLVD, O FALLON, MO 63368-7311
(314) 409-1453
Mailing address
247 PHEASANT POINT BLVD, O FALLON, MO 63368-7311
(314) 409-1453

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2013024758
MO

Other

Enumeration date
07/12/2013
Last updated
07/12/2013
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