Individual
DR. CARROLL BRUISTER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 MABUS, ACKERMAN, MS 39735
(662) 285-6039
Mailing address
11850 MS HWY 15, ACKERMAN, MS 39735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E6788
MS
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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