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1215538525
BRIAN CHARLES LONGO
HIGH RIDGE, MO
NPI
1215538525
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: MO 2009023448)
Enumeration Date
2020-11-03
Last Update Date
2020-11-03
Business Address
BRIAN CHARLES LONGO
2700 RIDGE POINT DR
HIGH RIDGE, MO 63049-2201
Phone number: 636-375-3130
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Mailing Address
BRIAN CHARLES LONGO
654 GREEN FOREST DR
FENTON, MO 63026-3461
Phone number:
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