Individual
DOUGLAS WADE SPERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4100 W WILLOW KNOLLS DR, PEORIA, IL 61615-4405
(309) 692-1814
(309) 692-1863
Mailing address
15675 KING RD, DANVERS, IL 61732-8409
(309) 838-0036
(309) 692-1863
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051032980
IL
Other
Enumeration date
08/23/2014
Last updated
08/23/2014
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