Healthcare Provider Details

I. General information

NPI: 1003199977
Provider Name (Legal Business Name): BRYAN E STRICKLAND R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 E SUNSHINE ST
SPRINGFIELD MO
65804-2045
US

IV. Provider business mailing address

1001 N 24TH ST
OZARK MO
65721-7882
US

V. Phone/Fax

Practice location:
  • Phone: 417-885-1274
  • Fax:
Mailing address:
  • Phone: 713-203-8627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2011027447
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: