Individual
MR. BOOTH KRISTOPHER HARNED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
909 E REPUBLIC RD, SPRINGFIELD, MO 65807-6004
(417) 883-5023
Mailing address
21400 S BRIAR RD, PECULIAR, MO 64078-9540
(816) 305-3680
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043188
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043188
MISSOURI BOARD OF PHARMACY LICENSE NUMBER
MO
Enumeration date
10/17/2011
Last updated
10/17/2011
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