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NPI Code Detail

MEDICARE: MISS BRADLEY DEAN REUER

MEDICARE: MISS BRADLEY DEAN REUER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist2920WY

General Provider Information

NPI Number : 1518950336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BRADLEY DEAN REUER
Provider Business Mailing Address
First Line : 512 KILLARNEY DR
Second Line :
City : CHEYENNE
State : WY
Zip : 82009-3506
Country : US
Telephone Number : 307-634-3136
Fax Number :
Provider Business Practice Location Address
First Line : 214 E 23RD ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3748
Country : US
Telephone Number : 307-633-7969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 07/08/2007

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Directions to “ MISS BRADLEY DEAN REUER ” Practice Location

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