Individual
MR. JOHN VICTOR TONJUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
201 S HIGHWAY 60, MARIONVILLE, MO 65705-9407
(417) 258-2526
(417) 463-2211
Mailing address
201 S HIGHWAY 60, P.O. BOX 217, MARIONVILLE, MO 65705-9407
(417) 258-2526
(417) 463-2211
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
040215
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040215
MISSOURI PHARMACIST LICENSE
MO
01
—
2629585
NCPDP PROVIDER IDENTIFICATION NUMBER
MO
05
—
601199508
—
MO
Enumeration date
03/05/2013
Last updated
03/05/2013
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