Most Relevant Information
Provider Data
| NPI Number: | 1003198318 |
| Provider Name: | AMANDA UPDEGRAFF PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 2011024492 |
Most Important Dates
| Enumeration Date: | 09/13/2011 |
| Last Updated: | 12/18/2022 |
Provider Practice Location
1490 MEXICO LOOP RD E
O FALLON
MO
633666015
Practice Location Phone/Fax
| Phone: | 6369781602 |
| Fax: |
Provider Mailing Location
1490 MEXICO LOOP RD E
O FALLON
MO
633666015
Provider Mailing Phone/Fax
| Phone: | 6369781602 |
| Fax: |