Individual
ERIN MICHELLE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2004 W MARLER LN, OZARK, MO 65721-7661
(417) 581-3288
Mailing address
5883 S NORTHERN RIDGE RD, SPRINGFIELD, MO 65810-1976
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2012028855
MO
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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