Individual
CALLIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1250 LAKE AVE, STORM LAKE, IA 50588-1997
(712) 732-1364
Mailing address
3260 HIGHWAY 18, RUTHVEN, IA 51358-7543
(712) 299-1943
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23930
IA
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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