Individual
GERALD ROBERT BRIZENDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
9525 E 21ST ST N, WICHITA, KS 67206-2946
(316) 631-1401
Mailing address
9525 E 21ST ST N, WICHITA, KS 67206-2946
(316) 631-1401
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8538
KS
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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