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Individual

DR. LEIGH FORD BRUNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARM. D.

Contact information

Practice address
90 COURT SQ, BLAKELY, GA 39823-2340
(229) 723-3441
(229) 723-8707
Mailing address
1330 INDIAN MOUNDS RD, BLAKELY, GA 39823-4407
(229) 724-2190
(229) 723-8707

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020815
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020815
GA PHARMACIST LICENSE
GA
Enumeration date
02/05/2008
Last updated
02/05/2008
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