Individual
JEREMY LAFOLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1191 W KANSAS ST, LIBERTY, MO 64068-2281
(816) 781-9347
Mailing address
2008 N WOODBINE RD, APT 5, SAINT JOSEPH, MO 64506-2439
(816) 617-4929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
1-14728
KS
183500000X
Pharmacist
Primary
2007019775
MO
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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