Individual
MR. BRUCE GROVE SPARKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
(843) 743-7295
Mailing address
135 OLD COURSE RD, SUMMERVILLE, SC 29485-6217
(843) 832-2418
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8724
OK
Other
Enumeration date
01/12/2006
Last updated
07/08/2007
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