Individual
MARIANA LIZZETTE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 BUFFALO RD, BUFFALO, WV 25033-9436
(304) 937-4204
(304) 937-4206
Mailing address
3707 BUFFALO RD, BUFFALO, WV 25033-9436
(304) 937-4204
(304) 937-4206
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0007655
WV
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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