Individual
BRENDEN WATAMANIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
12010 W 63RD ST, SHAWNEE, KS 66216-1867
(913) 268-8150
Mailing address
17270 W 86TH TER APT 12301, LENEXA, KS 66219-7101
(913) 426-5720
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-103790
KS
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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