Individual
DR. BRADLEY GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5121 ANTLE DR, LOUISVILLE, KY 40229-2872
(502) 966-2742
Mailing address
10501 VENADO DR, LOUISVILLE, KY 40291-4512
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013626
KY
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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