Individual
BROOKE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 CHEYENNE AVE, CANADIAN, TX 79014-3018
(806) 323-9616
Mailing address
200 CHEYENNE AVE, CANADIAN, TX 79014-3018
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
47296
TX
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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