Individual
TAYLOR FREDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 S CAMPBELL AVE, SPRINGFIELD, MO 65807-4914
(417) 881-6750
Mailing address
3315 S CAMPBELL AVE, SPRINGFIELD, MO 65807-4914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2021036291
MO
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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