Individual
JULIE BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 BELT LINE RD, COLLINSVILLE, IL 62234-4410
(618) 345-7811
Mailing address
6 ARBOR SPGS, TROY, IL 62294-2489
(618) 667-3240
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.288277
IL
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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