Individual
MAGGI BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2375 E SUNNYSIDE RD, IDAHO FALLS, ID 83404-8280
(208) 623-8614
Mailing address
2375 E SUNNYSIDE RD, IDAHO FALLS, ID 83404-8280
(208) 530-2039
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9191
ID
Other
Enumeration date
02/08/2021
Last updated
03/27/2026
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