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Individual

MR. CALVIN LEE BRYANT JR.

Active
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Individual

MR. CALVIN LEE BRYANT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051034870
IL
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
051034870
IL
1835P1200X
Pharmacotherapy Pharmacist
051034870
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051034870
PHARMACIST LICENSE #
IL
Enumeration date
06/22/2007
Last updated
11/25/2008
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