Liedke, Justin Clarke

Liedke, Justin Clarke is an individual health care provider with primary practice located at 100 Jason Dr , Troy MO 63379-1944. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Liedke, Justin Clarke can be contacted via phone (636) 462-5901.

Contact Information

Primary practice address
100 Jason Dr Troy MO 63379-1944
Phone: (636) 462-5901
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 2020018825 Missouri

Profile Details

NPI number 1639787328
LBN Legal business name Liedke, Justin Clarke
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2020
Last updated Jun 15th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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