Individual
BRUCE ALLEN STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
217 CHICAGO AVE, SAVANNA, IL 61074-1917
(815) 273-2713
Mailing address
13135 MESSMER RD, SAVANNA, IL 61074-8565
(815) 273-4344
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Enumeration date
12/16/2006
Last updated
07/08/2007
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