Individual
JASON K BRANNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1021 US HIGHWAY 45 N, ELDORADO, IL 62930-3767
(618) 273-3874
(618) 273-3843
Mailing address
565 KAREL PARK RD, RALEIGH, IL 62977-1528
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
012873
KY
183500000X
Pharmacist
Primary
051.291023
IL
Other
Enumeration date
07/21/2012
Last updated
07/21/2012
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