Individual
BRUCE MICHAEL FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
303 S JEFFERSON AVE, EATONTON, GA 31024-1129
(706) 485-6262
(706) 485-2122
Mailing address
303 S JEFFERSON AVE, EATONTON, GA 31024-1129
(706) 485-7945
(706) 485-2122
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012293
GA
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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