Individual
ADAM L THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
216 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1026
(314) 362-3395
(314) 362-1255
Mailing address
1214 EVANS AVE, KIRKWOOD, MO 63122-1227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2006024052
MO
183500000X
Pharmacist
—
IL
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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