MR. Michael Charles Cornwall, RPH

NPI #1376194134 in O Fallon, Illinois

Provider Information

NPI Number: 1376194134
Entity Type: Individual
Name: MR. Michael Charles Cornwall, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Sep 24, 2019
Last Updated: Sep 24, 2019

Practice Location

Address: 21 SHALLOWBROOK DR
City: O Fallon
State: Illinois
ZIP Code: 62269-1214
Phone: (618) 977-5537

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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