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Individual

MR. JERRY HAROLD BRUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7772 N 52ND DR, GLENDALE, AZ 85301
(623) 939-0798
Mailing address
7772 N 52ND DR, GLENDALE, AZ 85301-8618
(623) 939-0798

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S004723
AZ

Other

Enumeration date
06/05/2012
Last updated
06/05/2012
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