Individual
HEATHER ALLISON O'GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 STATE ST, AUGUSTA, KS 67010-1107
(316) 775-2289
Mailing address
12231 E DOVE HILL DR, DERBY, KS 67037-9583
(785) 280-3735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100919
KS
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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