Individual
BRUCE C CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
65 PORTLAND RD, KENNEBUNK, ME 04043-6742
(207) 985-9177
(207) 985-9209
Mailing address
PO BOX 271, KENNEBUNK, ME 04043-0271
(207) 752-4905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR4013
ME
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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