Individual
DEREK WAYNE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4526 NW ROSSELLA CT, RIVERSIDE, MO 64150-7826
(425) 305-8747
Mailing address
4526 NW ROSSELLA CT, RIVERSIDE, MO 64150-7826
(425) 305-8747
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2013022767
MO
Other
Enumeration date
07/20/2013
Last updated
10/14/2021
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