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Individual

BRAYTON JAMES REGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1901 PRAIRIE AVE, BELOIT, WI 53511-3133
(608) 365-2001
Mailing address
1901 PRAIRIE AVE, BELOIT, WI 53511-3133
(608) 365-2001

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.300560
IL
183500000X
Pharmacist
Primary
19241-40
WI
183500000X
Pharmacist
2017030954
MO

Other

Enumeration date
07/12/2018
Last updated
10/23/2021
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