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Individual

DR. BRANT DONALD HANISCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
705 S FREMONT ST, SHENANDOAH, IA 51601-1570
(712) 246-4033
(712) 246-1101
Mailing address
1592 A AVE, ESSEX, IA 51638-6019
(712) 215-1810

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
2008028041
MO
183500000X
Pharmacist
Primary
20982
IA

Other

Enumeration date
06/22/2020
Last updated
06/22/2020
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