Individual
MRS. AMANDA L RAUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
704 CAMBRIDGE BLVD, O FALLON, IL 62269-1964
(618) 632-6920
(618) 632-7228
Mailing address
502 W 3RD ST, AVISTON, IL 62216-3446
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.294315
IL
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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