Individual
GARY ZACKERY SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2304 W MONROE ST, SPRINGFIELD, IL 62704
(217) 546-9558
Mailing address
4368 CREEK DR, SPRINGFIELD, IL 62711-5904
(217) 698-9570
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.287086
IL
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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