Individual
RICHARD BRANTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 N MASSEY BLVD, NIXA, MO 65714-8118
(417) 724-9568
Mailing address
848 S COBBLE CREEK BLVD, NIXA, MO 65714-7872
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2016022255
MO
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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