Individual
STACY LEE BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
924 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3214
(870) 425-4127
(870) 425-4264
Mailing address
924 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3214
(870) 425-4127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD08690
AR
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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