Individual
KATIE LEE JOHANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
1266 ORCHARD VILLAGE LN, APT. J, BALLWIN, MO 63021-5476
(573) 864-5896
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2010025196
MO
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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