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1255615456
LISA D KIDWELL
LIBERTY, MO
NPI
1255615456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: MO 044171)
Enumeration Date
2011-10-06
Last Update Date
2011-10-06
Business Address
Mrs. LISA D KIDWELL
1191 W KANSAS ST
LIBERTY, MO 64068-2281
Phone number: 816-781-9347
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Mailing Address
Mrs. LISA D KIDWELL
3769 SE DEER RUN LN
LATHROP, MO 64465-8281
Phone number:
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