Individual
NICKALAUS CRAIG KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1349 E REPUBLIC RD, SPRINGFIELD, MO 65804-7204
(417) 887-9451
(417) 877-0674
Mailing address
1349 E REPUBLIC RD, SPRINGFIELD, MO 65804-7204
(417) 887-9451
(417) 877-0674
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2019030619
MO
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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