Organization
ST. JOHN'S PHYSICIAN & CLINIC
Active
Other names
St. John's Sisk Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROB SHOCKLEY (RETAIL COORDINATOR)
(417) 820-6624
Entity
Organization
Contact information
Practice address
101 NORTH MAIN STREET, LICKING, MO 65542
(573) 674-2922
(573) 674-4334
Mailing address
101 NORTH MAIN STREET, LICKING, MO 65542
(573) 674-2922
(573) 674-4334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
006040
MO
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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