STACEY M THACKER

EDWARDSVILLE, IL
NPI1962659664
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy261QP2300X Clinic/Center, Primary Care
(Licence: IL  051292099)
Enumeration Date2008-08-25
Last Update Date2008-08-25
Business Address
-- STACEY M THACKER Pharm D
200 UNIVERSITY PARK DR CAMPUS BOX 2000
EDWARDSVILLE, IL 62026-0001
Phone number: 618-650-5131
Mailing Address
-- STACEY M THACKER Pharm D
200 UNIVERSITY PARK DR CAMPUS BOX 2000
EDWARDSVILLE, IL 62026-0001
Phone number:
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