Individual
PHYLLIS IDUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4531 TROOST AVE, KANSAS CITY, MO 64110-1709
(816) 756-3608
(816) 756-1127
Mailing address
4531 TROOST AVE, KANSAS CITY, MO 64110-1709
(816) 756-3608
(816) 756-1127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2000172118
MO
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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