Individual
MR. JACK C STUCKMEYER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1 JEFFERSON BARRACKS RD, SAINT LOUIS, MO 63125-4181
(314) 894-6681
Mailing address
1311 FENTON HILLS RD, FENTON, MO 63026-3313
(636) 343-7014
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028659
MO
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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