Individual
DR. BRYCEN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1029 E MAIN ST, OLNEY, IL 62450-2625
(618) 395-2144
Mailing address
1029 E MAIN ST, OLNEY, IL 62450-2625
(618) 395-2144
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051293407
IL
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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