Individual
COLLIN JACOB NESTLEROAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1401 N 8TH ST, VANDALIA, IL 62471-1028
(618) 283-0196
(618) 283-9150
Mailing address
207 FIELD CROSSING DR APT 14, HIGHLAND, IL 62249-3966
(618) 292-3444
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051305857
IL
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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