Individual
NATHAN BOELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 E BROADWAY, COLUMBIA, MO 65203-4258
(573) 874-3562
Mailing address
222 E BROADWAY, COLUMBIA, MO 65203-4258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2017034441
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017034441
WALGREENS
MO
Enumeration date
08/14/2020
Last updated
08/14/2020
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