Individual
MR. MARK NELSON BRUECKL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH., MBA
Contact information
Practice address
100 N PITT ST, SUITE 400, ALEXANDRIA, VA 22314-3134
(703) 683-8416
(703) 683-8417
Mailing address
10 COLLINS CT, STAFFORD, VA 22556-6551
(540) 288-0792
(703) 683-8417
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207378
VA
183500000X
Pharmacist
030718
NY
Other
Enumeration date
05/12/2006
Last updated
07/08/2007
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