Richard Bak

NPI #1164768388 in Peoria, Illinois

Provider Information

NPI Number
1164768388
Entity Type
Individual
Name
Richard Bak
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
Dec 15, 2012
Last Updated
Dec 15, 2012

Practice Location

Address
5400 W SIENNA LN APT 5209
City
Peoria
ZIP Code
61615-7866
Phone
(309) 912-1225

Specialties & Taxonomy Codes

Specialty
Pharmacist

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