Individual
BRADLEY PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
10100 BROOK RD, T-1019, GLEN ALLEN, VA 23059-6514
(804) 262-4603
Mailing address
10100 BROOK RD, T-1019, GLEN ALLEN, VA 23059-6514
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202209128
VA
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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