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Individual

MR. BRAD ERIC EUSTACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
207 E 6TH ST, KINSLEY, KS 67547-1109
(620) 659-2481
(620) 659-2252
Mailing address
908 NILES AVE, KINSLEY, KS 67547-1418
(620) 659-2481
(620) 659-2252

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9455
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9455
PHARMACIST LICENSE
KS
Enumeration date
09/21/2006
Last updated
07/08/2007
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