Individual
BRYAN H BRISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1550 LAKE DR SE, GRAND RAPIDS, MI 49506-2704
(616) 235-0747
Mailing address
3949 FARR RD, FRUITPORT, MI 49415-9309
(231) 578-0658
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21251020901
MI
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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