Individual
MRS. JACQUELYN LEE BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
110 EAST BUTLER ST, FORT RECOVERY, OH 45846-0605
(419) 375-2323
(419) 375-4488
Mailing address
9365 W KLINGER RD, COVINGTON, OH 45318-9643
(937) 473-3031
(419) 375-4488
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-2-26302
OH
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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