Individual
REBECCA LYNN SANDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1102 N MASSEY BLVD, NIXA, MO 65714-7607
(417) 840-8288
Mailing address
2609 S 14TH AVE, OZARK, MO 65721-8720
(417) 840-8288
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044232
MO
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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