Individual
MR. FREDERICK DAVID BRUNNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1302 EDISON ST, BRUSH, CO 80723-2310
(970) 842-2416
(970) 842-4904
Mailing address
PO BOX 305, BRUSH, CO 80723-0305
(970) 842-2416
(970) 842-4904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601953
NCPDP SCRIPT NUMBER
CO
Enumeration date
08/22/2005
Last updated
07/08/2007
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