Individual
CALEB BRYANT SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 PITTSTON RD, LEBANON, VA 24266-4630
(276) 889-5914
Mailing address
403 GRAND VIEW CT, ROSEDALE, VA 24280-3597
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202219104
VA
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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