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1467729103
TALLY SHANNON STARK
SOUTH SIOUX CITY, NE
NPI
1467729103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: NE 10371)
Enumeration Date
2011-11-23
Last Update Date
2011-11-23
Business Address
Mrs. TALLY SHANNON STARK RP
1030 W 21ST ST
SOUTH SIOUX CITY, NE 68776-2661
Phone number: 402-494-8827
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Mailing Address
Mrs. TALLY SHANNON STARK RP
1030 W 21ST ST
SOUTH SIOUX CITY, NE 68776-2661
Phone number: 402-494-8827
Copy
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