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Individual

DONALD BRUCE GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
205 W 27TH ST, SCOTTSBLUFF, NE 69361-4307
(308) 635-3296
(308) 635-3891
Mailing address
205 W 27TH ST, SCOTTSBLUFF, NE 69361-4307
(308) 635-3296
(308) 635-3891

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
12203
CO
183500000X
Pharmacist
Primary
8461
NE

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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