SALLY SUZANNE FULLENKAMP

LA VISTA, NE
NPI1124303250
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: MO  2007028067)
Additional Taxonomies183500000X Pharmacist
(Licence: NE  13121)
Enumeration Date2011-10-20
Last Update Date2011-10-20
Business Address
SALLY SUZANNE FULLENKAMP PHARM D.
10314 FLORENCE CIR
LA VISTA, NE 68128-2372
Phone number: 402-504-9932
Mailing Address
SALLY SUZANNE FULLENKAMP PHARM D.
10314 FLORENCE CIR
LA VISTA, NE 68128-2372
Phone number: 402-504-9932