Individual
MR. BRIAN M TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
150 N MACDADE BLVD, GLENOLDEN, PA 19036-1224
(610) 586-5224
Mailing address
150 N MACDADE BLVD, GLENOLDEN, PA 19036-1224
(610) 586-5224
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP438087
PA
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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