Provider Demographics
NPI:1255944617
Name:KRONZ, BRYAN LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:LEE
Last Name:KRONZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-8112
Mailing Address - Country:US
Mailing Address - Phone:786-546-1708
Mailing Address - Fax:
Practice Address - Street 1:6330 W MARSHVILLE BLVD STE A
Practice Address - Street 2:
Practice Address - City:MARSHVILLE
Practice Address - State:NC
Practice Address - Zip Code:28103-1501
Practice Address - Country:US
Practice Address - Phone:704-624-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist