Individual
DR. BRYAN J MICKLEVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
16690 SWINGLEY RIDGE RD, CHESTERFIELD, MO 63017-0758
(636) 812-1473
Mailing address
16690 SWINGLEY RIDGE RD, CHESTERFIELD, MO 63017-0758
(636) 812-1473
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2006026094
MO
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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