Individual
DR. GREGORY TYLER BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2760 N DIRKSEN PKWY, SPRINGFIELD, IL 62702-1448
(217) 522-4054
(217) 522-4075
Mailing address
2300 GANDER RD, SPRINGFIELD, IL 62711-8199
(217) 652-9593
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051295476
IL
183500000X
Pharmacist
59336
TX
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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