Individual
BROOKE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
427 S ARIZONA AVE, HOLTON, KS 66436-1217
(785) 364-4619
(785) 364-2183
Mailing address
12862 OAK RIDGE DR, HOLTON, KS 66436-8064
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14633
KS
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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