Individual
MR. BRUCE JON RIENDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
N2585 PLAZA RD # 1409, WAUTOMA, WI 54982-7706
(920) 787-2090
(920) 787-4605
Mailing address
N2585 PLAZA RD # 1409, WAUTOMA, WI 54982-7706
(920) 787-2090
(920) 787-4605
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13298-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811941586
—
WI
Enumeration date
10/31/2012
Last updated
10/31/2012
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