Individual
SHANNON TATE WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1113 HAUCK DR, ROLLA, MO 65401-2565
(573) 364-9616
Mailing address
20995 CO. RD.3600, ST. JAMES, MO 65559
(573) 265-0102
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044753
MO
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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