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General NPI Number Information
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NPI Number | 1477554053
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Entity Type | Individual
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Provider Name | CRYSTAL JEAN BRYNER RPH, MBA, CDE
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9043 W OLIVE AVE
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City | PEORIA
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State | AZ
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Zip | 85345-7049
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Country | US
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Telephone | 623-334-3087
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Fax | 623-334-3257
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Provider Business Mailing Address
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Address Line | 3889 E DOUGLAS LOOP
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City | GILBERT
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State | AZ
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Zip | 85234-3056
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Country | US
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Telephone | 480-861-7858
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Fax | 623-334-3257
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S11174
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License Number State | AZ
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