Individual
MARY LOUISA BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6121
(928) 213-6136
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 213-6121
(928) 213-6136
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
7108
AZ
207Q00000X
Family Medicine Physician
Primary
2368
AZ
Other
Enumeration date
03/09/2006
Last updated
08/04/2008
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