Provider Demographics
NPI:1780024497
Name:BYERLEY, SAUNDRA (RPH)
Entity Type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:BYERLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4946
Mailing Address - Country:US
Mailing Address - Phone:636-327-7448
Mailing Address - Fax:
Practice Address - Street 1:106 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ELSBERRY
Practice Address - State:MO
Practice Address - Zip Code:63343-1345
Practice Address - Country:US
Practice Address - Phone:573-898-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO029761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist