Individual
BRANDON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
125 E MAIN ST, OSAWATOMIE, KS 66064-1125
(913) 755-4111
(913) 755-4111
Mailing address
125 E MAIN ST, OSAWATOMIE, KS 66064-1125
(913) 755-4111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100067
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-100067
KANSAS BOARD OF PHARMACY
KS
Enumeration date
02/20/2018
Last updated
02/20/2018
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