Individual
MURALI MANDAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1930 W GRAND ST, SPRINGFIELD, MO 65802-4870
(417) 863-6416
Mailing address
6307 MEADOWVIEW DR, OZARK, MO 65721-7262
(412) 526-0802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2007025913
MO
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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