BRYAN BACON

FORT LEAVENWORTH, KS
NPI1780984872
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: KS  1-16367)
Enumeration Date2010-10-24
Last Update Date2014-09-18
Business Address
-- BRYAN BACON RPh
550 POPE AVE
FORT LEAVENWORTH, KS 66027-2332
Phone number: 913-684-6070
Mailing Address
-- BRYAN BACON RPh
300 REAGAN DR
LANSING, KS 66043-1737
Phone number: 913-250-6701