Individual
NICKALAUS DAVID BRYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
650 N BISBEE AVE, WILLCOX, AZ 85643-1437
(520) 384-4612
Mailing address
490 W SMITH ST, SAINT DAVID, AZ 85630-6133
(520) 720-2629
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15445
AZ
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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