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Individual

MR. BRANDON V THACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
160 MARINER BLVD, 160 MARINER BLVD, SPRING HILL, FL 34609-5689
(352) 688-2305
(352) 666-2122
Mailing address
160 MARINER BLVD, 160 MARINER BLVD, SPRING HILL, FL 34609-5689
(352) 688-2305
(352) 666-2122

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH23820
MA
183500000X
Pharmacist
Primary
PS39614
FL

Other

Enumeration date
01/09/2013
Last updated
01/09/2013
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