Individual
MISS PAM J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
300 SE SALEM ST, OAK GROVE, MO 64075-9299
(816) 690-8600
(816) 625-8160
Mailing address
300 SE SALEM ST, OAK GROVE, MO 64075-9299
(816) 690-8600
(816) 625-8160
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2002008454
MO
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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