Individual
DESTRY BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 HIGHWAY 73, ATCHISON, KS 66002-5102
(913) 367-6142
Mailing address
1920 HIGHWAY 73, ATCHISON, KS 66002-5102
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-102978
KS
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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