Individual
JUSTIN VADUKUMCHERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2300 W WHITE OAKS DR, SPRINGFIELD, IL 62704-6423
(217) 698-5938
Mailing address
2300 W WHITE OAKS DR, SPRINGFIELD, IL 62704-6423
(217) 698-5938
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051302865
IL
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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