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Individual

BRANDT LARUE BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
430 HWY 51 NORTH, BROOKHAVEN, MS 39601
(601) 833-7455
Mailing address
430 HWY 51 NORTH, BROOKHAVEN, MS 39601
(601) 833-7455

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-07180
MS

Other

Enumeration date
10/02/2006
Last updated
07/08/2007
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