Individual
JEFF BIRKENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1391 BIG BEND RD, BALLWIN, MO 63021-7616
(636) 861-1988
Mailing address
13423 THORNHILL DR, SAINT LOUIS, MO 63131-1627
(314) 965-0393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2000168504
MO
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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