Individual
MR. FRED M TICHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
300 N MORLEY, MOBERTY, MO 65270-0957
(660) 263-0909
(660) 263-2124
Mailing address
PO BOX 657, 300 N MORLEY, MOBERTY, MO 65270-0957
(660) 263-0909
(660) 263-2124
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028656
MO
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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