Individual
DR. JENNALIE EVELYN BLACKWOOD
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) 289-6533
Mailing address
10300 BAPTIST CHURCH RD, SAINT LOUIS, MO 63123-5904
(314) 729-7854
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2005021409
MO
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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