RICHARD DARRELL BRADLEY

STATE LINE, MS
NPI1649317769
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: MS  E-6230)
Enumeration Date2007-01-30
Last Update Date2007-07-09
Business Address
Mr. RICHARD DARRELL BRADLEY RPh
194 MAIN ST.
STATE LINE, MS 39362-0159
Phone number: 601-848-7866
Mailing Address
Mr. RICHARD DARRELL BRADLEY RPh
PO BOX 159
STATE LINE, MS 39362-0159
Phone number: 601-848-7866