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Individual
MR. THOMAS JOHN BRADACH
Active
Individual
MR. THOMAS JOHN BRADACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8961040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8961040
STATE LICENSE NUMBER
WI
Enumeration date
09/10/2007
Last updated
09/10/2007
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