Individual
AYONGWI A TAZUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
810 S 37TH ST, BETHANY, MO 64424-2770
(660) 425-4410
Mailing address
6519 REEDER ST APT 203, SHAWNEE, KS 66203-3457
(913) 602-7424
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2019040564
MO
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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