Individual
BRUCE R. BURCH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
4204 BRENTWOOD DR, VALPARAISO, IN 46383-1374
(219) 462-1962
Mailing address
4204 BRENTWOOD DR, VALPARAISO, IN 46383-1374
(219) 462-1962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26012480A
IN
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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