Individual
BRIAN ALAN CASEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
937 PARK CIRCLE DR, BROOKFIELD, MO 64628-7920
(660) 258-7404
Mailing address
26713 IRA DR, BROOKFIELD, MO 64628-8391
(660) 734-0989
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043946
MO
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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