ETHAN VANDERSAND

Pharmacist

Active Individual
NPI: 1316297088

Practice Address

400A W CARPENTER ST
Jerseyville, IL 62052

Phone: (618) 498-6461

Specialties

Specialty Code Primary License
Pharmacist 183500000X Yes 051-289033 (IL)

Frequently Asked Questions

NPI 1316297088 is the National Provider Identifier for ETHAN VANDERSAND, a Pharmacist provider located in Jerseyville, IL. This NPI was enumerated on September 10, 2012.
ETHAN VANDERSAND practices at 400A W CARPENTER ST, Jerseyville, IL 62052.

Quick Facts

NPI
1316297088
Type
Individual
Enumerated
Sep 10, 2012
Last Updated
Sep 10, 2012

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