Individual
LISA MARIE CILLESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03233944-2
OH
183500000X
Pharmacist
2015027215
MO
183500000X
Pharmacist
PH235251
MA
Other
Enumeration date
06/23/2014
Last updated
08/07/2015
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