Individual
CRYSTAL LE-ANN DORNBACH-POOJARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM. D.
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0514
Mailing address
302 TRACI DAWN DR, ROLLA, MO 65401-8259
(314) 365-5735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2010028707
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
04/19/2010
Last updated
12/21/2020
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