Individual
DENNIS A EDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1490 MEXICO LOOP RD E, O FALLON, MO 63366-6015
(636) 978-1602
Mailing address
1490 MEXICO LOOP RD E, O FALLON, MO 63366-6015
(636) 978-1602
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028543
MO
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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