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Individual

MRS. GRACIE BROOKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.PH.

Contact information

Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
1061 WILD PLUM DR, KLAMATH FALLS, OR 97601-1962
(541) 205-3232

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
17346
NV
183500000X
Pharmacist
31461
TX
183500000X
Pharmacist
Primary
RPH011086
OR

Other

Enumeration date
06/25/2009
Last updated
06/25/2009
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