Individual
MR. TERRY DALE KERMOADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
520 EAST 10TH STREET, SUPERIOR, NE 68978
(402) 879-4555
Mailing address
1313 N KANSAS ST, SUPERIOR, NE 68978-1035
(402) 879-3281
(402) 879-4924
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8694
NE
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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