Individual
JUSTIN TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
255 NW VICTORIA DR STE B, LEES SUMMIT, MO 64086-4709
(855) 937-7273
Mailing address
940 NW PRYOR RD APT 207, LEES SUMMIT, MO 64081-1145
(816) 507-5694
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
2021050249
MO
183500000X
Pharmacist
23686
NV
183500000X
Pharmacist
Primary
23985
IA
183500000X
Pharmacist
70344
TX
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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