Most Relevant Information
Provider Data
| NPI Number: | 1003429580 |
| Provider Name: | AMANDA L COOK |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 2012020929 |
Most Important Dates
| Enumeration Date: | 08/25/2020 |
| Last Updated: | 08/25/2020 |
Provider Practice Location
100 N GRAND AVE
HOUSTON
MO
654831222
Practice Location Phone/Fax
| Phone: | 4172602384 |
| Fax: |
Provider Mailing Location
100 N GRAND AVE
HOUSTON
MO
654831222
Provider Mailing Phone/Fax
| Phone: | 4172602384 |
| Fax: |