Individual
THERESA ANN BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
900 W IDAHO ST, KALISPELL, MT 59901-3844
(406) 257-7556
Mailing address
PO BOX 1584, EUREKA, MT 59917-1584
(406) 889-3678
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2771
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2771
PHARMACY LICENSE
MT
Enumeration date
05/24/2007
Last updated
07/08/2007
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