Individual
CHARLES FREDRICK BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6935 PINES RD, SHREVEPORT, LA 71129-2515
(318) 688-7912
(318) 688-1351
Mailing address
6935 PINES RD, SHREVEPORT, LA 71129-2515
(318) 688-7912
(318) 688-1351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17793
LA
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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