Individual
KELSEY BRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2490 NE HIGHWAY 99W, MCMINNVILLE, OR 97128-9204
(503) 435-3125
Mailing address
2490 NE HIGHWAY 99W, MCMINNVILLE, OR 97128-9204
(503) 435-3125
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0015446
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0015446
OR
Other
Enumeration date
08/23/2016
Last updated
02/21/2017
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